Classification Of ACJ Dislocation

Question 1

What is the system called?

Answer 1

Rockwood Classification System

Question 2

Type 1

Answer 2

Sprain of AC lig (all lig's intact)
Deltopectoral fascia intact
Radio graphic exam normal (CC distance/AC appearance)
ACJ tenderness
Minimal pain with UE motion
No pain in coracoclavicular interspace

Question 3

Type 2

Answer 3

Distal clavicle unstable horizontally (either anteriorly or posteriorly)
May be vertical instability (minimal or absent)
Disruption of AC lig’s
CC lig’s sprained
Deltopectoral fascia intact
Radiographic: CC distance < 25%/AC appearance widened
Distal clavicle slightly superior to acromion
Mobile to palpation
Tenderness in coracoclavicular space
Minimal pain with UE motion

Question 4

Type 3

Answer 4

Distal clavicle unstable horizontally and vertically
Disruption of AC lig’s, CC lig’s, and deltopectoral fascia
Radiographic: CC distance 25-30%/AC appearance widened
Distal clavicle appears superior to acromion
Mobile to palpation
Tenderness in coracoclavicular space
Coracoclavicular widening evident
ACJ reducible w/ upward force @ elbow
Severe pain w/ motion

Question 5

Type 4

Answer 5

Distal clavicle posteriorly displaced into trap and into P skin
Disruption of AC lig’s, CC lig’s and deltopectoral fascia
Radiographic: CC distance increased/AC appearance - posterior clavicle displacement
May be anterior dislocation of SCJ or P dislocation of ACJ
Tenderness in coracoclavicular space
ACJ irreducible
Pain w/ motion

Question 6

Type 5

Answer 6

More severe form of Type 3
Deltoid and trap stripped off acromion and clavicle
Disruption of AC lig’s, CC lig’s, and deltopectoral fascia
Radiographic: CC distance increased 2-3 fold
Shoulder presents w/ severe droop to downward displacement of humerus
May be sx from traction on brachial plexus
ACJ irreducible

Question 7

Type 6

Answer 7

I dislocation of distal clavicle
Disruption of AC lig’s and deltopectoral fascia
Coracoclavicular lig’s intact
Distal clavicle rests in subacromial or subcoracoid position
Radiographic: CC distance decreased
MOI: hyperabduction and ER w/ retraction of scapula (high-energy trauma)
Accompanied w/ concomitant pathology
Shoulder has flat appearance (prominent acromion)
Associated clavicle and upper rib fx’s
May be sx from traction on brachial plexus
ACJ irreducible