A literature review was performed to clarify available information which influences decisions whether to advise a young adult @entity1 to undergo surgery for a severely displaced @entity3029 . Twenty-four papers were retrieved yielding 1172 @entity1 of whom the mean followup for the 833 surgically treated @entity1 was 43.7 months and not surgically treated was 60.4 months. Of the 24 papers, only five reported surgical and conservative outcomes; two of these papers used prospective randomized methodology and three used nonrandomized methodology. Fourteen papers reported surgical outcome only and five papers reported conservative outcome only. Overall, 88% of surgically treated @entity1 and 87% of nonsurgically treated @entity1 had a satisfactory outcome. Complications most commonly listed were (surgically treated versus nonsurgically treated): need for further surgery (59% versus 6%), @entity281 (6% versus 1%), and @entity85 (3% versus 37%). Return to activity was no quicker with surgery. @entity158 was not any more common without surgery. Range of movement was more frequently normal or near normal without surgery (95% versus 86% if surgically treated) and so was strength (92% versus 87%). Meta-analysis of the four studies including data from surgical and conservative therapy showed on significant benefit from surgery. Power studies suggest that to show a statistically significant benefit from surgery, large studies would be required, which, given the relative incidence of these injuries, would probably be multicenter and therefore vulnerable to methodologic difficulties. There does not seem to be any reason to recommend an operative procedure to a @entity1 with a Rockwood et al @entity130 based on the evidence currently available.

XXXX . Conservative or surgical therapy.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection'] @entity158 :: ('MESH:D010146', 'Disease') :: ['Pain'] @entity85 :: ('MESH:D009140', 'Disease') :: ['deformity'] @entity130 :: ('MESH:D014947', 'Disease') :: ['Type III injury'] @entity3029 :: ('MESH:D004204', 'Disease') :: ['acromioclavicular dislocation']
@entity3029 :: (MESH:D004204,Disease) :: ['Acromioclavicular dislocation']
