The acromioclavicular joint is located at the top of the shoulder. It is the joint between the lateral (outer) end of the clavicle (collar bone) and the acromion (a projection from the scapula, or shoulder blade, which is located at the point of the shoulder). Acromioclavicular dislocation is one of the most common shoulder problems treated in general orthopaedic practice.
This review identified three trials, involving 174 mainly male participants. The surgical interventions involved fixation using screws, pins or wires; and conservative treatment involved resting the arm with an arm sling or similar. None of the trials found significant differences between the two groups in shoulder function at one year. However, having surgery delayed the return to work and activities and also required a routine second operation to remove wires and pins. Pooled results on treatment failure, generally requiring an operation, showed no difference between the two groups. However, there were some fixation failures particularly involving the movement and breakage of wires in one trial. There was not enough reliable evidence to draw conclusions about whether or when surgery is more appropriate for acromioclavicular dislocations.