Acromiovlavicular Joint Separations Flashcards
The AC joint is vulnerable to
injury in collision
sports and in activities requiring repetitive overhead
motions
AC joint injuries male to female ratio
males 5:1
characterized by
torn but intact AC and CC
ligaments.
■ No instability or displacement.
type I
involve a complete disruption of the AC ligament with a torn but intact CC ligament. ■ Both instability and displacement.
type II
(Dislocation) – characterized by complete rupture of the AC and CC ligaments. AC joint is wide and distal clavicle raised above acromion. ■ Both instability and displacement.
type III
determined by the position of the dislocated distal clavicle
type IV - VI
which type AC injuries will you not see in office
type IV- VI
defined by posterior displacement of
the clavicle relative to the acromion with buttonholing
through the trapezius muscle.
type IV
the clavicle is widely displaced
superiorly relative to the acromion as a result of
disruption of muscle attachments.
type V
(rare) - characterized by inferior
displacement of the distal clavicle below the acromial
process or the coracoid process.
type VI
never surgical (1-2 weeks of repair)
type I
not surgical but longer recovery (month repair)
type II
can go either way: surgery or non invasive care. ADL’s dependent
type III
The patient places his hand on the opposite shoulder, while the
examiner exerts force horizontally. Again, the presence of pain
indicates possible pathology.
Cross-Arm Horizontal Adduction Test
* gold standard *
activity modification may
include the use of a sling / immobilization until
symptoms subside, enough healing time has
been allowed and range of motion is reasonably
comfortable.
type I
most orthopedic surgeons
recommend use of a sling for 1-2 weeks or until
symptoms subside.
■ Rehabilitation emphasizing maintaining or
regaining range of motion.
type II
Some controversy surrounds type III – it can be treated in the
same way as I and II but will take 6-12 weeks to heal
type III
Kenny Hower Splint is used in what type AC injury
type III
all but type ___ have an anatomical defect
I
diffuse, lateral shoulder pain
and/or local AC-joint pain.
■ Pain at night is common.
■ Usually due to inflammation of the RC tendon.
■ Crossed-arm adduction of the involved shoulder
with additional passive adduction by the
examiner also aggravates pain.
AC joint OA
The treatment for AC arthritis is
NSAIDS
co-morbidity to AC OA
■ Rotator cuff degeneration / tear
■ D/T intrusion of osteophytes into the
suprahumeral space.
reduce by having patient
lay with a towel roll between scapula. Traction
and abduction of the arm with slight pressure on
the clavicle
anterior dislocation of SC joint
