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Studies comparing the results of non-operative and surgical treatment of type III AC separations have shown that surgical interventions do not have a substantial benefit.
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Bannister et al concluded that conservative management of type III injuries yielded a return to full shoulder kinematics more quickly with less complications. Surgery is the preferred treatment, but there has been a reported case of the successful use of manual reductions, which converted the type IV to a type II.
Remove the sling several times a day to gently move the arm in a pendulum motion: Apply cold to the shoulder for 20 minutes at a time as needed to reduce pain and swelling.
Remove the sling several times a day: Lean over and do pendulum exercises for 3 to 5 minutes every 1 to 2 hours. To wash under the operated arm, bend over at the waist and let the arm passively come away from the body.
It is safe to wash under the arm in this position. This is the same position as the pendulum exercise.
Protocols on active movement and sling use will vary depending on the surgeon and the procedure done. Some will prescribe no active arm movements and the need for a sling for up to 6 weeks.
Others may allow sling use as needed and active movement immediately, for example up to 90 degrees in the first two weeks slowly progressing from there. Post-operative rehabilitation then follows similar guidelines as that for Type I and II injuries.
Treatment consists initially of ROM exercises, followed by progressive strengthening. Rehabilitation needs to be followed through to full strength and mobility in order to avoid incidence of persistent pain and instability of the AC joint.
Cleveland clinic journal of medicine ; 74 7: Joints ; 2 2: Surgical anatomy of the acromioclavicular and sternoclavicular joints.
Surg Clin North Am. Anatomical observations on the acromioclavicular joint in supporting ligaments. Am J Sports Med ;15 3: Pathology and Intervention in Musculoskeletal Rehabilitation.Advertise Your Pathology Fellowships With Us! All fellowship ads appear for one year on our Fellowship page.
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