(iv) Disorders of the acromioclavicular joint and distal clavicle

The acromioclavicular joint (ACJ) is a common source of pathology in patients of all age groups and lifestyles. Young patients, particularly those engaged in contact sports, often suffer injuries that result in instability of the ACJ. Advances in arthroscopic surgery and implant technology have opened new avenues for the treatment of these injuries. Despite this, in many cases, there remains considerable controversy as to whether surgical intervention is warranted in the acute setting. Fractures of the distal clavicle may occur in any age group, and have a reputation for having a high incidence of non-union. The development of anatomically contoured locking plates offers the potential for improved outcomes in this difficult group of fractures. The ACJ is a common site for degenerative change and advances in arthroscopic techniques have changed the way this condition is managed. The aim of this article is to give the general reader an overview of the current understanding of these conditions and provide an up-to-date account of the treatment options available.