Acromioclavicular joint dislocations: incidence, injury profile, and patient characteristics from a prospective case series

Abstract

Background: Acromioclavicular joint (ACJ) dislocations are common but evidence regarding the epidemiology of these injuries is incomplete. This study aims to describe the incidence, injury mechanisms, distribution of classifications, risk factors, and patient characteristics for ACJ dislocations in a general population.

Methods: Inclusion was performed prospectively during a 4-year period with the following criteria; age 18-75 years, shoulder trauma within 2 weeks, a clinical suspicion of ACJ dislocation, and radiographs that excluded fracture. The injuries were classified according to the Rockwood system, and epidemiologic variables were obtained. Rockwood types 1-2 were defined as low-grade injuries and types 3-6 as high-grade. Age groups were defined with a young group (18-39 years), an intermediate group (40-59), and an old group (60-75).

Results: A total of 158 patients were included; 139 were male and the mean age was 39 years (range 18-74). There were 73 low-grade and 85 high-grade injuries. The incidence was 2.0 [95% confidence interval (CI) = 1.7-2.4] per 10,000 person-years, gradually decreasing with higher age, groupwise. The incidence rate ratio (IRR) for men vs. women was 7.6 (95% CI = 4.7-12.6) and IRR >1 was seen comparing younger age groups to older. Odds ratio calculations showed that risk factors for high-grade injury were older age and traffic accidents.

Conclusion: The incidence of ACJ dislocations was 2.0 per 10,000 person-years in a general population. Male gender and younger age group were risk factors for injury, whereas the risk for high-grade injuries were greater in older patients and after traffic accidents.

Keywords: Acromioclavicular joint; classification; dislocation; epidemiology; incidence; separation.

Figure 1

Flow chart describing inclusion of patients.