Comparison of operative versus non-operative management in Grade III acromioclavicular joint injuries.

Abstract

Objective: To compare functional and radiological outcomes of operative versus non-operative management in Rockwood Grade III AC joint injuries. Study Design: Prospective Comparative study. Setting: Ghurki Trust & Teaching Hospital, Lahore. Period: 2^nd January 2026 to 20^th April, 2026. Methods: The number was 94 patients with 2 equal groups (n=47). Group A was treated conservatively with sling immobilization and physiotherapy, whereas Group B was treated with ORIF using a clavicular hook plate. The Constant score was used to measure functional outcome and coracoclavicular (CC) distance to evaluate radiological outcome at 3 months follow-up. SPSS version 27 was used to analyze data. Results: The mean Constant score was significantly higher in the conservative group (86.4 ± 6.8) compared to the operative group (80.9 ± 7.5) (p = 0.0003). In contrast, the operative group demonstrated significantly better radiological reduction with a lower CC distance (9.8 ± 1.9 mm) compared to the conservative group (12.1 ± 2.3 mm) (p = 0.0001). Stratified analysis showed no significant effect of age, side affected, or presence of arthritis on outcomes (p > 0.05). Conclusion: Non-operative management provides superior functional outcomes, whereas operative fixation achieves better anatomical restoration. Both approaches demonstrate acceptable outcomes, and treatment selection should be individualized based on patient-specific factors.