Abstract

Background. Acromioclavicular joint dislocations constitute from 6.8 to 26.1 % of all dislocations and rank third after dislocations of the shoulder and forearm. In the structure of acute traumatic injuries to the shoulder girdle, the proportion of acromioclavicular joint dislocations is above 12 %. These injuries are more common in men of the most working age (from 30 to 40 years) and in athletes engaged in contact sports. Poor outcomes of surgical treatment vary from 9 to 12 %. The aim of the study: to determine modern principles of surgical treatment for acromioclavicular joint dislocations, problematic issues and advanced solutions. Materials and methods. Analysis of literature sources was carried out using PubMed, UpToDate, Scopus, Web of Science, MEDLINE, The Cochrane Library, Embase, Global Health, CyberLeninka databases by search: acromioclavicular joint dislocations, surgical treatment. Results. The most common classification of acromioclavicular joint dislocations is Rockwood classification that includes six dislocation types. Despite the quite detailed classification of injuries to the acromioclavicular ligament according to Rockwood, the Tossy classification is more simplified, but meets practical needs, and distinguishes three types of damage. Stabilization of the clavicle with metal structures is realized by fixing to the coracoid process or acromion of the scapula, the latter is a priority. The disadvantages of the most used metal fixators were identified that require their optimization and development of innovative structures. The reasoned direction regarding static stabilizer restoration is plastic replacement of both ligamentous complexes. Conclusions. A priority direction is to stabilize the clavicle by fixing its acromial end to the acromion of the scapula with metal structures among which a hook plate and the Weber method are the most used. However, significant disadvantages in their use necessitate the development of innovative designs. A promising direction for the restoration of static clavicle stabilizers is surgical methods that combine the restoration of the coracoclavicular and acromioclavicular ligaments. The objective need to create channels for grafts leads to a weakening in the mechanical strength of the bony structures, so research regarding the direction, diameter, and location of these channels requires further investigation.

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