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Should we fix grade III AC joint injuries in athletes?

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The acromioclavicular joint is commonly injured in sports. Injury typically occurs from direct impact from a collision as in football or hockey or from a fall onto the shoulder with the arm adducted which is a common occurrence in many recreational sports.

Grade I and II injuries are treated nonoperatively. Grade IV, V and VI injuries are treated surgically. There is some controversy in the management of grade III injuries as to whether surgical or nonoperative management is best.

Eric McCarty, MD, presents a case of a 24-year-old professional mountain biker who fell onto his left shoulder, which was his dominant side. The athlete was taken to the local medical facility near the mountain. The most significant finding was a deformity at his acromioclavicular (AC) joint. How would you proceed in treatment? To read the full Case Studies in Sports Medicine blog, click here.