Rockwood type VI acromioclavicular (AC) joint dislocations are extremely rare high-energy injuries characterized by inferior displacement of the distal clavicle and are often associated with complex shoulder girdle injury. We report the case of a 36-year-old male who sustained a Gustilo-Anderson type IIIA open Rockwood type VIb AC joint dislocation associated with a Neer two-part proximal humerus fracture-dislocation and an ipsilateral scapular spine fracture following a road traffic accident. The patient underwent early surgical debridement and single-stage operative management, including open reduction and internal fixation of the proximal humerus using a locking plate (Proximal Humerus Multiple Locked Plate; Sharma Orthopedic, Gujarat, India) and stabilization of the AC joint with a coracoclavicular screw (Cortical Screw 3.5 mm; Sharma Orthopedic, Gujarat, India), while the scapular fracture was managed conservatively. At the 12-month follow-up, the patient demonstrated excellent radiological and functional outcomes, without complications. This case highlights the importance of a high index of suspicion for associated injuries in high-grade AC joint dislocations and shows that early, single-stage surgical stabilization using sound biomechanical principles can restore anatomy and function even in rare and complex injury patterns.
Sonam et al. (2026) studied this question.