The cases of 127 patients who had an acute dislocation of the
acromioclavicular joint were studied. Fifty-two patients, with an average
follow-up of 10.8 years, were managed operatively, and seventy-five
patients, with an average follow-up of 9.5 years, were managed
non-operatively. Using a rating system that included subjective, objective,
and roentgenographic criteria, it did not appear that reduction of the
acromioclavicular joint was necessary to obtain consistently good results.
Operative management, using either coracoclavicular or acromioclavicular
fixation, was associated with a higher rate of complications than
non-operative treatment. The use of a sling for four weeks without
reduction of the joint, followed by a graduated exercise program, led to
acceptable clinical results. In patients who had persistent pain and
stiffness of the acromioclavicular joint, or in whom symptomatic
post-traumatic arthritis developed, resection of the distal part of the
clavicle reliably produced significant improvement.