Transcript ACROMIOCLAVICULAR JOINT INJURIES

THE ACROMIOCLAVICULAR JOINT
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Location:
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Top of the shoulder
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Composed of:
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2 bones: Acromion and Clavicle
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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)
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Grade 1: Tenderness over joint and even throughout entire
shoulder
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Grade 2: Grade 1 symptoms, swelling and Bruising around
shoulder area
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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):
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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:
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Immobilize the arm using a sling or brace
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Cold therapy
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A sports injury specialist or doctor may tape the joint into correct
healing position
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Anti-Inflammatory medicine to reduce swelling and pain
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After some healing physiotherapy is recommended to further
healing
TREATMENTS
Surgical:
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reconstruction of ligaments
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trimming the end of the collarbone to prevent contact with the
acromion (Mumford Procedure)
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plates and pins may be inserted to improve stability
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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
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Avoid sports until injury has healed
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Continue to move shoulder to prevent “frozen” or stiff shoulders
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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