{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:21:50Z","timestamp":1787505710957,"version":"build-2736575974"},"reference-count":30,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Acromioclavicular (AC) joint dislocations are common in young athletes. The optimal management of Rockwood type 3 injuries, which involve a complete tear of both the AC and coracoclavicular (CC) ligaments, remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose\/Hypothesis:<\/jats:title>\n                    <jats:p>The purpose of this study was to compare the clinical outcomes of surgical and nonoperative treatment of type 3 AC joint dislocations. The hypothesis was that surgical treatment would result in superior functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Randomized controlled trial; Level of evidence, 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 70 patients (mean age, 31.2 \u00b1 8.1 years) with acute type 3 AC joint dislocations were randomized to the surgical (modified Weaver-Dunn technique) (n = 35) and nonoperative treatment group (n = 35). The inclusion criteria were as follows: adults aged &gt;18 years diagnosed with grade 3 AC dislocation within 21 days of the injury; no history of AC dislocation or previous surgery in the affected shoulder; and no associated fractures involving the acromion, coracoid, or clavicle. The exclusion criteria were as follows: failure to adhere to the follow-up schedule; improper performance of radiological examinations; or noncompliance with the prescribed rehabilitation protocol. Ten patients were lost to follow-up, resulting in a final sample size of 60 patients (30 per group). The primary outcome was the Disabilities of the Arm, Shoulder, and Hand (DASH) score at 12 months. Secondary outcomes included the University of California\u2013Los Angeles (UCLA) score, scapular dyskinesis, range of motion, radiographic alignment, cosmetic satisfaction, return to sport, and complications. Follow-up was conducted over 24 months. All statistical tests were 2-tailed, and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05 was considered statistically significant. No adjustments were made for multiple comparisons because of the exploratory nature of secondary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      No significant differences were found in DASH scores (11.4 vs 10.63;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .179) at final follow-up. The surgical group showed significantly higher UCLA scores (36.07 vs 33.74;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and lower rates of cosmetic dissatisfaction (14.8% vs 44%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .017), although the range of motion, return to sport, scapular dyskinesis, and complication rates did not differ between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Surgical management of type 3 AC joint dislocations resulted in similar DASH scores and range of motion compared with nonoperative management, although some secondary outcomes\u2014including higher UCLA scores and cosmetic satisfaction scores\u2014favored surgery.<\/jats:p>\n                    <jats:p>The trial was registered in the Brazilian Registry of Clinical Trials (RBR-4r6jhy6).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251395220","type":"journal-article","created":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T08:00:51Z","timestamp":1767254451000},"page":"118-127","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Functional, Radiological, and Scapular Motion Evaluation of Surgical Versus Nonsurgical Treatment of Type 3 Acromioclavicular Dislocations: A Randomized Controlled Trial With 24 months\u2019 Follow-up"],"prefix":"10.1177","volume":"54","author":[{"given":"Paulo Henrique Schmidt","family":"Lara","sequence":"first","affiliation":[{"name":"Sports Medicine Discipline, Paulista School of Medicine\u2013UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Clinical Radiology-EPM-UNIFESP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewerton Borges de Sousa","family":"Lima","sequence":"additional","affiliation":[{"name":"Sports Medicine Discipline, Paulista School of Medicine\u2013UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Clinical Radiology-EPM-UNIFESP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Vicente","family":"Andreoli","sequence":"additional","affiliation":[{"name":"Sports Medicine Discipline, Paulista School of Medicine\u2013UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Clinical Radiology-EPM-UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Sports Medicine and Physical Activity-EPM-UNIFESP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto de Castro","family":"Pochini","sequence":"additional","affiliation":[{"name":"Sports Medicine Discipline, Paulista School of Medicine\u2013UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Clinical Radiology-EPM-UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Sports Medicine and Physical Activity-EPM-UNIFESP, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benno","family":"Ejnisman","sequence":"additional","affiliation":[{"name":"Sports Medicine Discipline, Paulista School of Medicine\u2013UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Clinical Radiology-EPM-UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Sports Medicine and Physical Activity-EPM-UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Santoro","family":"Belangero","sequence":"additional","affiliation":[{"name":"Sports Medicine Discipline, Paulista School of Medicine\u2013UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Clinical Radiology-EPM-UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Postgraduate Program in Sports Medicine and Physical Activity-EPM-UNIFESP, S\u00e3o Paulo, Brazil"},{"name":"Hospital Israelita Albert Einstein, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519831013"},{"issue":"4","key":"e_1_3_3_3_2","first-page":"315","article-title":"Type III acromioclavicular dislocation: mid term results after operative and non-operative treatment","volume":"68","author":"\u00c1lvarez-\u00c1lvarez L","year":"2024","unstructured":"\u00c1lvarez-\u00c1lvarez L, Cela-L\u00f3pez M, Gonz\u00e1lez-Rodriguez E, Garc\u00eda-Perez, Rodriguez-Arenas M, Castro-Men\u00e9ndez. 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