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ACJDC

Evaluating the frequency, management and outcomes of severe acromioclavicular injuries (Grade III and above) in the UK.

Full title

A prospective multi-centre observational cohort study of ACJ injuries

Background

Injuries to the joint that connects the collar bone (clavicle) to a part of the shoulder blade (scapula) is called the acromion. This joint is called the ‘AC Joint’ or ‘ACJ’.

Treatment of these injuries usually involves using a simple sling to support the arm but may sometimes involve surgery.

Research suggests that minor injuries to this area do not require an operation and a period of rest in a sling is all that is required to allow healing. There is also good research evidence to show that patients who have severe injuries to the ACJ would benefit from surgery. Evidence is less clear in moderate injuries, which are much more common.

Operations for this injury may include different types of surgery involving use of metal implants (pins, screws and plates), artificial ligaments, sutures or wires. In previous studies, evaluations of treatments have largely been undertaken in single hospitals and therefore do not provide a broad perspective.

What we did

The aim of this study was to collect information on what treatments are currently being provided within 12 NHS hospital Trusts in the United Kingdom (UK).

We also assessed how well patients get back to their normal activities following their treatment.

54 patients were recruited within four weeks of injury regardless of treatment type over a one-year period.

What we found

Patient reported outcomes and healthcare resource use was collected at 6 and 12 months after injury.

Accounting for Rockwood grade, age, gender and dominant arm injury, patients who had an operation had a statistically lower Oxford Shoulder Score (OSS) at baseline and at 6 months than those who did not have an operation.

There was no statistical difference at 12 months.

There was no clear preference of fixation in the 10 patients that received an operation.

Chief investigator

Dr Helen Ingoe

South Tees Hospitals NHS Foundation Trust

Funder

British Elbow and Shoulder Society (BESS) pump priming grant

Study status

Published