Background/Objectives: Acromioclavicular (AC) joint injuries account for 9–12% of shoulder injuries, predominantly affecting young male athletes. While conservative treatment is established for Rockwood type I–II injuries and surgery is widely regarded as indicated for type V–VI, management of type III–IV injuries remains controversial. Biomechanical studies have shown superior results in combined reconstruction of the coracoclavicular and AC ligament complex, however clinical data is scarce. Therefore, the present study aimed to assess whether the addition of an acromioclavicular ligament reconstruction to an isolated coracoclavicular repair offers superior clinical and radiographic outcomes in the treatment of acute AC joint dislocations. Methods: A retrospective multicenter study was conducted on patients with Rockwood type III–VI AC joint injuries who underwent surgical treatment between 2019 and 2024. Patients were divided into two groups: isolated CC reconstruction (group I) and combined CC and AC ligament reconstruction (group II). Clinical outcome was assessed using patient-reported outcome measures (American Shoulder and Elbow Surgeons Score, Simple Shoulder Test, Single Assessment Numeric Evaluation, Visual Analogue Scale) and radiographic evaluations were performed regularly up to 6 months postoperatively. Results: Fifty-five patients (94.5% male, mean age 33.5 ± 10.9 years) were included in the present study. High patient satisfaction (group I: ASES 96.3 ± 7.9, SST 99.2 ± 3.3, SANE 95.3 ± 7.0; group II: ASES 95.8 ± 8.8, SST 96.8 ± 8.2, SANE 93.6 ± 12.8) was documented in both groups, but no significant differences were observed. The median coracoclavicular loosening ratio was 24.7% in the CC group and 32.6% in the CC and AC ligament reconstruction group (p = 0.830). Five complications occurred: two infections and three revision surgeries due to excessive secondary dislocations. Conclusions: Both surgical techniques demonstrated excellent clinical outcomes. In this study combined CC and AC ligament reconstruction did not yield superior clinical or radiological results compared to isolated coracoclavicular reconstruction. Our findings suggest that a routine AC ligament augmentation may not be necessary in all patients. Further randomized controlled trials are needed to validate these results.

Introduction: Heterotopic ossifications (HOs) are a well-known complication following total hip arthroplasty. Yet only little is known about the development of HOs following a femoral fracture and intramedullary stabilization in polytraumatized patients. Thus, the present study aimed to investigate whether the development of HOs is being observed more frequently in patients suffering polytrauma compared to those with single-extremity trauma. Materials and Methods: The retrospective outcome study was conducted at our level I trauma center. All patients admitted from 2010 to 2020 were included if they (1) presented with multiple injuries (≥2 body regions), (2) had an Injury Severity Score ≥16, (3) suffered a femoral fracture, and (4) were treated with intramedullary stabilization. Furthermore, a control group was established to match the polytrauma group (sex, age), who were suffering from single-extremity trauma (femoral fracture) which was treated with intramedullary stabilization. Subsequently, X-rays of the hip were performed and evaluated for up to one-year post-trauma. Results: Our study group consisted of 36 patients in total (91.7% male; mean age 39.4 ± 17.4 years, range: 18–82 years). The polytrauma (PT) group included 12 patients (mean age 39.5 years, median ISS 28), whereas the control group (single-extremity-trauma) included 24 patients (mean age 39.3 years). We documented HOs in nine (75%) patients in the PT group vs. five (20.8%) patients in the single-extremity group (p = 0.03). Conclusion: In this study, we were able to demonstrate that heterotopic ossifications are being observed significantly more frequently in patients suffering from polytrauma in comparison to patients with single-extremity trauma following intramedullary stabilization after a femoral fracture.