Dislocations of the Acromioclavicular joint
Flash Presentation on ACJ Injuries
For more than 40 years, the treatment of acute AC joint subluxation and dislocation has been a source of controversy among orthopaedic surgeons
Divided into:
-
Those who pridefully report their good results after surgical treatment using one of the numerous methods of fixation developed with or without biomechanical research
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Those who disdainfully report their excellent results after closed (or non) treatment and point to open management of these injuries as "tantamount to shooting a dove with an elephant hunter's rifle . . . the antithesis of sound practice."
Anatomy
Classification of AC separations (Post and Rockwood)
Fracture Type |
Injury Pattern |
Surgery |
I |
AC joint capsule partially disrupted |
Not indicated |
II |
AC joint capsule and CC ligaments partially disrupted |
Not indicated |
III |
AC joint capsule and CC ligaments completely disrupted |
Optional |
IV |
Type III + avulsion of CC ligament from clavicle, with the distal clavicle displaced posteriorly into or through the trapezius |
Indicated |
V |
Type III but with exaggeration of the vertical displacement of the clavicle from the scapula- coracoclavicular interspace 100- 300% greater than the normal side |
Indicated |
VI |
Type III + inferior dislocation of lateral end of clavicle |
Indicated |
* AC, acromioclavicular; CC, coracoclavicular
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