Characteristics And Comparison of Tossy and Rockwood Classifications for Acromioclavicular Joint Separations

Abstract

Acromioclavicular joint (AC joint) is one of the four articulations that make up the shoulder joint. Injuries related to the shoulder joint often damage the AC joint. Since AC joint separation is usually caused by external force applied to the shoulder, it is one of the most familiar shoulder injuries in sports, especially sports with body contact such as ice hockey, football, and basketball. As the force that causes injury varies, there are different grades of severity of the AC joint separation. This study focuses on two main classifications (Tossy classification and Rockwood classification) of the severity of the AC joint separation and discusses the corresponding treatments as well as the criticisms of each classification. Tossy three-degree classification is straightforward that could be categorized quickly after diagnosis. Grade 1 requires the use of a well-designed sling, Grade 2 needs a specific treatment plan, and Grade 3 requires open surgeries. Rockwood's six-type classification is more detailed than the three-degree classification and represents the complicated pathophysiology. Types I and II are recommended for non-operative treatments, Type III should adopt non-operative treatment firstly, and then the operative management. Types IV, V, and VI need surgical treatments.