Ipsilateral Rockwood type V acromioclavicular joint dislocation and midshaft clavicle fracture: A case report.

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Abstract

Conflict of interest statement: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article. 18. Cost Eff Resour Alloc. 2023 Sep 13;21(1):63. doi: 10.1186/s12962-023-00468-2. Operative vs. conservative treatment of AC-Joint Dislocations Rockwood grade ≥ III -An economical and clinical evaluation. Niehaus R(1)(2), Schleicher A(3), Ammann E(3), Kriechling P(3), Lenz CG(3), Masanneck M(4), Hodel S(3), Eid K(3). Author information: (1)Apollon Hochschule für Gesundheitswirtschaft, Apollon Hochschule für Gesundheitswirtschaft, Universitätsallee 18, 28359, Bremen, Germany. richard.niehaus@web.de. (2)Department of Orthopedic Surgery, Kantonsspital Baden, Im Ergel 1, Baden, 5404, Switzerland. richard.niehaus@web.de. (3)Department of Orthopedic Surgery, Kantonsspital Baden, Im Ergel 1, Baden, 5404, Switzerland. (4)Apollon Hochschule für Gesundheitswirtschaft, Apollon Hochschule für Gesundheitswirtschaft, Universitätsallee 18, 28359, Bremen, Germany. Erratum in Cost Eff Resour Alloc. 2023 Oct 9;21(1):74. doi: 10.1186/s12962-023-00483-3. INTRODUCTION: Acromioclavicular joint dislocations (ACD) are one of the most common shoulder injuries. There is no consensus in how to treat higher graded ACD ≥ Rockwood grade III. This study compares operative versus conservative treatment regarding costs and clinical outcome parameters. MATERIALS AND METHODS: This retrospective, consecutive case-control-study includes 14 patients. Seven operatively treated patients were matched, by Rockwood grade, with seven conservatively treated patients. The cost was extracted out of the clinical- and insurance-based cost sheets and furthermore these include the loss of earnings. Clinical examination, demographic data as well as different outcome-questionnaires were recorded. RESULTS: There were no significant differences between operative and conservative treated patients for outcome Questionnaires. Of note, there was a significantly higher incidence of tenderness over the AC-joint (p = 0.0038) postoperatively. As expected, economical evaluation showed various findings in favor of the conservative treatment. The costs for medical services (11012.39vs.1163.81USD; p = 0.0061), days of hospitalization (3.3vs.0days; p  III) compared to conservative is economically inefficient. Under consideration of clinical comparable results, indications for operative treatment should be set very carefully. © 2023. BioMed Central Ltd., part of Springer Nature. DOI: 10.1186/s12962-023-00468-2 PMCID: PMC10498558