March 4, 2026Journal of Pediatric Orthopaedics0 citations
Nonoperative Treatment of Low-grade AC Joint Injuries in Pediatric Athletes
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Key Points
- The study aims to characterize management strategies and return-to-sport outcomes for low-grade AC joint injuries in pediatric athletes.
- Identified patients under 18 years with AC joint injuries between 2014 and 2024 from large hospital databases.
- Collected data on demographics, injury patterns, management approaches, and return-to-sport status.
- Analyzed treatments, such as sling immobilization, physical therapy, and rest.
- A total of 108 patients were analyzed; 95% had low-grade AC joint injuries managed nonoperatively.
- Sling immobilization was used in 40%, with physical therapy in 29% and rest in 17%.
- At least 48% had documented return-to-sport dates, with a median RTS time of 21 days.
- Concomitant injuries were linked to longer RTS times, highlighting the impact of additional injuries on recovery.
Abstract
Background: Pediatric acromioclavicular (AC) joint injuries are rarely reported, and data on return-to-sport rates (RTS) in this population are limited. This study aims to characterize management strategies and return-to-sport outcomes following AC joint injuries in pediatric athletes, addressing a gap in the current literature. Methods: Patients under 18 years of age who sustained an AC joint injury between March 1, 2014, and March 1, 2024, were identified using databases from a large tertiary referral hospital and a large children’s hospital. Extracted data included patient demographics, injury patterns, management approaches, and RTS status. Results: A total of 108 patients (110 shoulders) were included (74% male; mean age, 12.77±2.13 y; range 8 to 17 years). Low-grade injuries accounted for 95% of cases, and all injuries were managed nonoperatively. Sling immobilization was used in 40%, physical therapy (PT) in 29%, rest in 17%, and a combination of sling and PT in 15%. The most common mechanisms were football (29, 26%), motor vehicle collisions (11, 10%), and soccer (10, 9%). At least 48% (52) of patients had documented return-to-sport dates, with the median RTS time being 21 days (IQR 14 to 49.45 d). Concomitant injury was associated with a longer RTS time (HR 0.33, 95% CI 0.16-0.69, P =0.003). Conclusions: In this cohort of pediatric athletes, AC joint injuries were predominantly low-grade and managed nonoperatively. Of the patients with documented follow-up and RTS, the median RTS time was 3 weeks. These findings reinforce the favorable prognosis of nonoperative treatment for low-grade injuries in this population. Given the rarity of pediatric AC joint injuries and the limited published data, reporting these outcomes is essential to guide evidence-based management in pediatric sports medicine. Level of Evidence: IV: retrospective cohort study.
Cite This Study
Reed et al. (Mon,) studied this question.