AC Injuries Flashcards
AC ligaments
superior AC ligament
inferior AC ligament
coracoacromial lig
coracoclavicular lig
superior AC ligament
covers superior joint
going from upper part of acromion to upper part of clavicle
inferior AC ligament
thinner than superior AC lig
covers underside of AC joint
coracoacromial lig
strong
triangular band
running b/w coracoid process and acromion
coracoclavicular lig
connects clavicle to coracoid process
how is the coracoclavicular lig divided
into trapezoid and conoid ligs
trapezoid –> coracoclavicular
more lateral
conoid –> coracoclavicular
medial to trapzoid
MOI
acute
chronic
acute –> MOI
traumatic
traumatic –> acute –> MOI
fall onto shoulder w/ arm ADD
FOOSH
chronic -> MOI
atraumatic
post traumatic
atraumatic –> chronic –> MOI
generalized OA
inflammatory arthritis
classification of AC injuries
types 1-6
type 1 –> AC & coracoclavicular ligs
isolated sprain of AC ligs
coracoclavicular ligs in tact
@ AC joint–> phase 1
tenderness and mild pain
what might a type 1 injury have
high painful arc
160-180 degrees
what is painful –> type 1
resisted HADD
intervention –> type 1
ice
pain free AROM
same as for other sprains
type 2 –> AC & coracoclavicular ligs
AC lig is disrupted
coracoclavicular lig is sprained
appearance of AC joint –> type 2
wider
may have slight vertical separation compared to uninjured side
@ AC joint –> type 2
moderate to severe pain
@ coracoclavicular space –> type 2
tenderness
PROM –> type 2
all painful at ends of ranges
most in HADD
intervention –> type 2
ice
pain free AROM/PROM
progressive strengthening in pain free ranges
type 3 –> AC lig
AC ligament disrupted
AC joint –> type 3
dislocated
distal clavicle displaced superior to acromion
coracoclavicular interspace –> type 3
25-100% greater than uninjured side
post trauma UE position –> type 3
adducted
appearance –> type 3
visible gap b/w acromion and clavicle
ROM –> type 3
PROM painless if done carefully
AROM all painful
piano key phenomenon –> type 3
push down inferior on clavicle
it springs back
AC lig –> type 4
disrupted
AC joint –> type 4
dislocated
displaced posteriorly
coracoclavicular ligs –> type 4
completely disrupted
intervention –> type 4-6
surgery indicated
AC joint –> type 5
like type 3
distal clavicle is displaced superior to acromion
but w/ distal clavicle displaced severely upward
AC and coracoclavicular ligs –> type 5
disrupted
AC dislocates … –> type 5
w/ 100-300% greater distance b/w clavicle and scap compared to uninjured side
AC and coracoclavicular ligs –> type 6
disrupted
AC joint –> type 6
dislocated
clavicle displaced inferiorly
clavicle displaced inferiorly –> type 6
coracoclavicular interspace reversed w/ clavicle inferior to acromion
what may be present –> type 6
accompanying brachial plexus lesion
appearance –> type 6
top of shoulder is flat compared to uninjured side
types 1,2,3,5
superior displacement of clavicle w/ respect to acromion
differ in severity of injury and amount of displacement
types 1 and 2
MOI usually FOOSH or blow to lateral shoulder
types 3 and 4
usually involve dislocation and distal clavicle fx
coracoclavicular lig disrupted
type 4
posterior clavicle displacement
type 6
inferior displacement of the clavicle
