Scapular dyskinesis and SICK syndrome in patients with chronic type III acromioclavicular dislocation. Results of rehabilitation

Purpose: Recently, scapular dyskinesis and SICK scapula syndrome have been related to type III acromioclavicular dislocation conservatively treated. Aim: To evaluate the efficacy of the rehabilitation program proposed for scapular dyskinesis secondary to acromioclavicular dislocation after 2 years of at least one hour per week of rehabilitation. Methods: 24 patients with a diagnosis of chronic type III acromioclavicular dislocation and scapular dyskinesis were enrolled in this study.4 Of these, 14 had a SICK Syndrome. Adopted rehabilitation protocol consists of 10 exercises of strengthening and stretching of the scapulae. Follow-up was performed at 24 months with clinical measurements of scapular position and clinical evaluation of scapular motion. For evaluating SICK scapula syndrome, we applied the SICK Scapula Rating Scale. Shoulder function was evaluated with Constant Score and Subjective Shoulder Value. Results: At 24 months of follow-up, 18/23 patients (78,26%) did not present scapular dyskinesis. SICK scapula syndrome was observed in 4 (50%) of patients with scapular dyskinesis. The Scapula Rating Scale score in 4 patients with SICK scapula was 7,5 points. After 24 months of rehabilitation, mean Constant score was 80 points for injured side and 92 points for healthy side. At final follow-up, the mean SSV was 75% on the injured side. Conclusions: Patients who developed scapular dyskinesis due to a type III acromioclavicular dislocation conservatively treated can resolve the condition with a rehabilitation program in the majority of cases (about 70%). Also those with SICK syndrome can effectively treat it with this program. Nevertheless, shoulder function and patient’s satisfaction still remain compromised.