Aftercare/Perspective/Prediction | Therapy of acromioclavicular joint dislocation

Aftercare/Perspective/Prediction

Movement exercises of the shoulder already begin in the days following the operation of the acromioclavicular joint dislocation under physiotherapeutic guidance. Movements above the horizontal should be avoided for 4-6 weeks. Rockwood I or Tossy I injuries usually heal without consequences.

The prognosis for conservatively treated Rockwood II or Tossy II injuries is also good. If the shoulder girdle is subjected to heavy strain at work (overhead work) or during sports, painful acromioclavicular joint arthrosis can develop later.The prognosis for all surgically treated acromioclavicular joint fractures is also good, but depends on the achieved acromioclavicular joint stability, the loss of reduction and the stress on the shoulder girdle in everyday life. Physiotherapeutic exercise treatment should be carried out until full shoulder joint mobility is achieved. Remaining acromioclavicular joint instability can lead to a loss of function and chronic complaints of the shoulder. However, an ACG blast is also a risk factor for ACG arthrosis if it is treated surgically.

Complications of acromioclavicular dislocation

  • Loss of reduction: After intraoperative adjustment of the acromioclavicular joint, the result can often not be fully maintained during follow-up treatment. Depending on the surgical procedure for the acromioclavicular joint, the lateral clavicle end may move slightly upwards again.
  • Infection/wound healing disorder: The soft tissue mantle over the collarbone is very thin. The risk of postoperative infection is not insignificant.
  • Metal loosening: Metal loosening or even metal fractures also occur in the case of acromioclavicular joint dislocation.

    Strong static and dynamic forces act on the collarbone.

  • Cosmetically disturbing scarring: Especially in young people and skin incisions parallel to the collarbone, the chest muscle tension can lead to excessive, cosmetically disturbing scarring (keloid). For this reason, the sabre cut is recommended for young people. Due to its vertical course, it is not exposed to such pulling forces. A disadvantage can be a poorer overview during the operation.
  • Vascular and nerve injuries: General risk with every operation, but also depending on the surgical procedure. Post-operative bleeding as well as sensory and movement disorders of the arm are possible.

All articles in this series:

  1. Therapy of acromioclavicular joint dislocation
  2. Aftercare/Perspective/Prediction