Rockwood V Acromioclavicular Dislocation Pain Assessment: Results of Conservative Management

Abstract

Introduction: Rockwood type V acromioclavicular (AC) dislocations involve 100–300% displacement relative to the contralateral clavicle and are usually treated surgically. However, recent studies suggest that conservative treatment can offer comparable results.

Objective: To evaluate the clinical outcomes of conservative treatment for Rockwood type V AC dislocations after six months of follow-up, analyzing pain using the numerical analog scale (NAS), recovery of functional shoulder range of motion, and cosmetic satisfaction.

Materials and Methods: A descriptive study of patients with Rockwood type V AC dislocations treated conservatively between 2019 and 2024. The percentage of initial radiographic displacement, recovery of functional range of motion, pain (NAS), and reported cosmetic satisfaction were evaluated at six months.

Results: Twenty-two patients were included (72.7% male, mean age 43.2 ± 13.3 years). At six months, 80% (n = 18) presented with flexion ≥120°, abduction ≥130°, external rotation ≥60°, and internal rotation ≥100°. The final NAS score was ≤1 in 77.2% (n = 17) of cases. However, only 4.5% (n = 1) reported cosmetic satisfaction, despite the absence of pain and functional independence. No correlation was found between the initial displacement percentage and other clinical variables.

Conclusions: Conservative treatment for Rockwood V LAC offers favorable functional results with minimal residual pain. However, cosmetic dissatisfaction remains a limitation and should be considered in therapeutic decision-making. Long-term follow-up is required to evaluate its sustained functional impact.