• Injury · Oct 2022

    Review Meta Analysis

    Acute Rockwood type III ACJ dislocation: Conservative vs surgical approach. A systematic review and meta-analysis of current concepts in literature.

    • Giai ViaRiccardoRDepartment of Orthopaedics and Traumatology, University of Turin, CTO Torino, Italy., Francesco Bosco, Fortunato Giustra, Alessandro Dario Lavia, Stefano Artiaco, Salvatore Risitano, Matteo Giachino, and Alessandro Massè.
    • Department of Orthopaedics and Traumatology, University of Turin, CTO Torino, Italy.
    • Injury. 2022 Oct 1; 53 (10): 3094-3101.

    BackgroundThe most appropriate approach, surgical or conservative, for acute Rockwood type III acromioclavicular joint (ACJ) dislocation is still under debate. In literature, similar results have been reported with both treatments. This review aims to analyze the operative and conservative outcomes of acute Rockwood type III ACJ dislocation to guide orthopedics in daily practice.Material/MethodsA systematic review and meta-analysis were performed according to PRISMA guidelines. A PICOS template was developed. Four databases (Pubmed, Scopus, Embase, and Medline) were searched, and eligible articles were evaluated according to the Levels of Evidence. The methodological quality of the articles was assessed through the ROBINS-I and the RoB-2. This review was registered in PROSPERO.ResultsFive studies were included, with 73 and 110 patients treated with conservative and surgical approaches, respectively. Three outcomes, Constant Score (CS), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were analyzed. Only the acromioclavicular distance was statistically significant in the surgical group over the conservative one (p < 0.05); instead, the other two outcomes demonstrated no statistical difference between the two groups.ConclusionsThis study demonstrated statistically significant superiority of the mean ACD score in the radiological follow-up of the surgical group compared to the conservative one. A tendency for better radiological and clinical results, mean CCD and CS scores, respectively, although non statically significant, was reported in the surgical group. High-quality randomized controlled clinical trials should help determine the most appropriate treatment for acute Rockwood type III ACJ dislocations.Copyright © 2022. Published by Elsevier Ltd.

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