Current treatment of acromioclavicular separations

Purpose of review: As the treatment of acromioclavicular separations has evolved, nonoperative and operative management continues to be debated. By discussing current literature this review will attempt to provide some direction on the current treatment of this common disorder. Recent findings: Recent literature has attempted to clarify the role for nonoperative treatment as well as the best methods for operative reconstruction of A/C separations. The popularity of nonoperative management continues to increase, but when surgery is recommended the Weaver–Dunn reconstruction remains the most common surgical technique. Recent articles continue to support its use. New reconstructive options, termed anatomic, have been developed that incorporate autograft or allograft tendons into the reconstructions and have been shown to provide improved biomechanics, but clinical benefit has not been shown. In addition, arthroscopic techniques continue to develop, which have led to a renewed interest in acute surgical repair. Regardless of the reconstructive option chosen, the role for distal clavicle resection continues to be debated and will also be reviewed. Summary: The majority of acromioclavicular separations can still be managed nonoperatively. When surgery is deemed necessary, multiple options exist, and there is no uniform consensus. Further study is necessary to determine which surgical option provides optimal treatment.