ACROMIOCLA

VICULA

R JOIN

T

INJU

RIES -

SHOULD

ER

SEPARAT

ION

BY IS

LAY

DUFF, M

EGHAN MAGNUSSON A

ND BECCA G

RAZIANO

THE ACROMIOCLAVICULAR JOINT

- Location:

- Top of the shoulder

- Composed of:

- 2 bones: Acromion and Clavicle

- 2 ligaments: Acromioclavicular and Coracoclavicular (seperated into conoid and the trapezoid sectors)

- Ligaments provide stability for the joint; tearing of the ligament can lead to acromioclavicular sprains and seperations

HOW DOES THIS INJURY OCCUR?

-Sharp blows to the top of the shoulder

-Examples:

• Sports-related accidents (Mostly high contact sports ie. Football and rugby)

•Falling (ie. off a bike or horse)

•Car accident

SYMPTOMS OF SHOULDER SEPARATION

Symptoms depend of the severity of the injury

(classified by grades)

- Grade 1: Tenderness over joint and even throughout entire shoulder

- Grade 2: Grade 1 symptoms, swelling and Bruising around shoulder area

- Grade 3: Grade 1 & 2 symptoms, popping sensation, bump on shoulder, pain while moving shoulder (especially when raising arm above shoulder)

CLASSIFICATIONS OF THE JOINT INJURY

BROKEN DOWN INTO 3 GRADE & 6 TYPES (based on severity)

Grade One: TENDER BUT NOT SEPERATED

Type I (Grade 1):

- Injury to the capsule that surrounds the AC join

- Bones are still in position

- Primary symptom is pain

CLASSIFICATION OF THE JOINT INJURY

Grade Two: SLIGHT SEPERATION OF THE CLAVICLE FROM THE SHOULDER

Type II (Grade 2):- AC (Acromioclavicular) joint capsule and ligament

are partially torn - Patients may have small bump over the AC joint

Type III (Grade 2):- Same type of injury as type II shoulder separation,

yet more significant- Patients have large bump over the AC joint

CLASSIFICATIONS OF THE JOINT INJURY

Grade Three: FULL SEPARATION OF SHOULDER

Type IV (Grade 3):

- unusual injury where the clavicle is pushed behind the AC joint

Type V (Grade 3):

- exaggerated type III injury

- the muscle above the AC joint is punctured by the end of the clavicle causing a significant bump over the injury

Type VI (Grade 3):

- also exceedingly rare- the clavicle is pushed downwards, and becomes lodged below

the coracoid (part of the scapula)

QUICK LITTLE VIDEO...

http://www.youtube.com/watch?v=OfcSvG-dgbY

TREATMENTS

Nonsurgical:

-  Immobilize the arm using a sling or brace

- Cold therapy

- A sports injury specialist or doctor may tape the joint into correct healing position

- Anti-Inflammatory medicine to reduce swelling and pain

- After some healing physiotherapy is recommended to further healing 

TREATMENTS

Surgical: 

-  reconstruction of ligaments

- trimming the end of the collarbone to prevent contact with the acromion (Mumford Procedure)

- plates and pins may be inserted to improve stability

- major seperations often require the Weaver-Dunn Procedure (A 2-inch incision is made over the joint, the end of the clavicle is removed, ligaments are transferred from the underside of the acromion into the cut end of the clavicle to replace torn ligaments)

REHABILITATION

- Avoid sports until injury has healed

- Continue to move shoulder to prevent “frozen” or stiff shoulders

- With doctor’s permission; work with trainer or physical therapist to strengthen shoulder (to do shoulder exercises)

Post-Rehab Prevention

- Pain-free range of motion of AC joint must be present before returning to sports

- Rehab exercises can help re-strengthen joint

-Taping of AC joint can support and protect joint by applying pressure to clavicle

-Shoulder supports and braces are available

-If pain persists: patient can use ice and anti-inflammatory medication to reduce pain