ACJoint Injury

ROYDEN DOMINIC DSOUZA

INDEX• Epidemiology• Etiology• Anatomy• Classification• Clinical Features• Radiology• Treatment• Rehab

• Contact Sports• Young Males• Motor Vehicle

collisions

EPIDEMIOLOGY

• Blow to the apex of the shoulder.• Fall on shoulder with arms adducted.

ETIOLOGY

ANATOMY• Type : Diarthrodial• Stability : •

• Capsule, Deltoid & Trapezius.

Costoclavicular LigamentAcromioclavicular

Horizontal Vertical

Rockwood Classification

Type AC lig. CC lig. Muscles Clavicle

Type 1 Sprain Intact Intact Intact

Type 2 Rupture Sprain (D) & (T) Minimal Detachment

Intact

Type 3 Rupture Rupture (D) & (T) Detached Elevated, but <100 % displacement

Type 4 Rupture Rupture (D) & (T) Detached Posteriorly displaced clavicle into trapezius

Type 5 Rupture Rupture (D) & (T) Detached Elevated, but >100%

Type 6 Rupture Rupture Displaced

(D) – Deltoid , (T) – Trapezius , AC – Acromioclavicular , CC – Costoclavicular , lig-Ligament

• Pain• Tenderness• Swelling• Step Deformity

Clinical Features

• X- Ray• Bilateral AP• Axillary ( To diagnose Type 4)• Zanca

Radiology

• Non operative : • Type 1,2 and most of the type 3 patients.

Treatment

ICE RESTSLING

• Operative : • For type 3,4,5 & 6• Techniques :• ORIF with CC Screw fixation• ORIF with CC Suture fixation• CC Ligament reconstruction

Treatment

• GOALS• ROM• STRENGTH• PAIN• RETURN TO FUNCTION

Rehab

References

• http://emedicine.medscape.com/article/92337-overview

• http://www.jospt.org/doi/pdfplus/10.2519/jospt.1997.25.6.390