الفهرس 
Acute Acromioclavicular Joint DislocationOnly 14 pages are availabe for public view
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Abstract
Background: Acute acromioclavicular (AC) joint dislocations are common and account for approximately 12% of all shoulder girdle injuries. The incidence is estimated to be 1.8 per 10,000 inhabitants per year in urban areas. Over 50% of these injuries are sustained by patients in their second or third decade of life, with men being affected more often than women at a ratio of 8.5 to 1.6 AC separation mainly occurs after sports or road accidents as a result of a direct blow to the lateral shoulder girdle or indirect trauma such as a fall on the adducted outstretched arm.
Aim of the Work: This study aims to summarize and analyze the current evidences comparing Suspensory devices and synthetic ligament reconstruction for treatment of AC joint dislocations type (3-4). Primary outcome: Pain assessed using VAS score and Constant–Murley score (CMS). Secondary outcome: Rate of complications and Coraco-clavicular distance.
Materials and Method: A Systematic Review and Meta-Analysis study, searched Medline via PubMed, SCOPUS, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) from their inception till April 2020. The search retrieved 2089 unique records. We then retained 57 potentially eligible records for full-texts screening. Finally, 16 studies were included.
Results: The present systematic review and meta-analysis demonstrates that both suspensory devices and synthetic ligaments are associated with significant improvement in AC joint function, as demonstrated by the increase in the CMS. Besides, both techniques reduced the AC pain, as indicated by the decreased in the VAS. The overall effect estimates showed that rate of postoperative complications was low in both techniques. While in indirect comparison, there was no statistically significant difference between the two techniques in the results of CMS, VAS and postoperative complications.
Conclusion: In conclusion, there is no consensus regarding the most effective technique for management of acute AC joint dislocation (grade III-VI). The suspensory devices and synthetic ligaments are safe and reliable and reduce the risk of iatrogenic damage when used to treat high-grade AC joint injuries. In acute high-grade AC joint injuries, suspensory fixation had higher postoperative functional CMS when compared to synthetic ligaments. The lack of universal and widely accepted outcome results as well as injury classification systems makes it difficult for outcome-based studies with controls to be performed. A multi-institutional study involving a standardized patient reported outcome system would provide strong evidence as to which surgical method yields greater patient outcomes.