AANA/SOMOS Enduring Shoulder Program 2024-Acute 3rd Degree A-C Separation in Air Force Football Player

Video Transcription

Video Summary

The discussion focuses on acute third-degree (Type III) acromioclavicular (AC) joint separations, common in athletes due to shoulder trauma. Dr. Buddy Savoie advocates nonoperative treatment using a scapular brace that repositions the scapula, enabling many athletes to return to play quickly, noting high complication rates with surgery. He emphasizes the complexity of AC joint injuries involving four key ligaments and critiques the numerous surgical techniques, highlighting poor outcomes and frequent failures even in expert hands. Dr. Andy Sheehan concurs, noting most Type III injuries can be managed nonoperatively but considers surgery for cases with associated pathologies (like rotator cuff tears) or significant horizontal instability (Type III B). He prefers arthroscopic-assisted stabilization with grafts when surgery is chosen, typically in acute cases within one week. Imaging like bilateral Zanca and cross-body Alexander views aids diagnosis. The panel agrees that managing patient expectations and preserving clavicle length are important, and that surgery requires careful technique and understanding of anatomy to minimize complications.

Asset Caption

Anything But Surgery (Felix (Buddy) H. Savoie III, M.D.) vs. Surgery NOW (Andrew J. Sheean, M.D.
Discussion, moderated by Julie A. Dodds, M.D.
Technique Video: AC Reconstruction/Repair (James R. Bailey, M.D., FAANA)

Keywords

Acromioclavicular joint

Type III AC separation

Nonoperative treatment

Scapular brace

Surgical complications

Arthroscopic stabilization