The Acromioclavicular joint is where your collarbone (clavicle) meets the top-most potion of your shoulder blade (acromion); thus the word – acromioclavicular. Strong ligaments hold them together. These ligaments are the coraco-clavicular ligament and acroclavicular ligaments.
Acromioclavicular joint dislocation is particularly common in collision sports such as football, judo, and rugby -to name a few. It’s also a problem for those who participate in swimming, horseback riding, biking, or skateboarding. The most common mechanism of injury is a fall injuring the tip of the shoulder.
Most patients injured the shoulder moments before seeking medical attention. A dislocated shoulder is usually associated with an obvious dislocated appearance, pain, swelling, and/or the inability to move your shoulders and arms.
Through hands on examining, pull-apart testing, and flexion exercise, our orthopedic specialists can determine the extent of the injury and properly grade the injury.
Though symptoms could show obvious signs of dislocation, images are still needed to confirm the diagnosis.
Shoulder X-ray will then show obvious changes especially in the acromioclavicular joint.
Ultrasound can be used to visualize bones, as well as soft tissues surrounding the joint.
Magnetic Resonance Imaging (MRI) can be used to tell if a bone is broken when x-ray results are not clear. MRI is done more commonly than other tests to check for bone and joint problems. It shows abnormal tissues and ligaments more clearly.
Sometimes the deformity can be minimal and may not be apparent on the images. The orthopedic specialist may then request another view of the area, but this time asking the patient to carry weight on the affected shoulder.
AJD is graded I-VI depending on the degree of separation to the acromion from the clavicle with weight applied to the arm. It can be categorized as follows:
With minimal deformity, conservative treatments may be done to alleviate symptoms. This would include the following:
For severe cases such as when patients feel persistent pain and have apparent deformity, surgery may be done to fix the deformity, regain alignment of the shoulder, and avoid further dislocation.
Surgery aims to reconstruct the damaged ligaments and may require the use of pins, plates, screws or sutures. Your orthopedic specialist may recommend trimming of the collarbone so that there will be no friction to the acromion. If the ligaments are broken, a reconstruction may be done. Surgery may be done in different ways, some are as follows
As there has been a disruption to the normal anatomy, complications may occur especially when the doctor’s advice is not followed precisely. The most common complications of surgery include infection, nerve and blood vessel injurys, continued pain or stiffness, fracture, unsuccessful surgery, ligaments re-tear, and revision surgery.
Always remember that with any treatment, whether conservative or surgical, your shoulder needs rehabilitation to regain range of motion, stability, and strength. A sling may be needed to support and protect the shoulder.
Do take note that all movements and activities above the shoulder level must be avoided for first 12 weeks following surgery. This being said, driving should be avoided as well.
Some surgeries especially those that affects the ligament can be delayed, so there is no rush with treatments. Your orthopedic specialist can tell you more about this and may help you weigh the pros and cons of having treatments.
Have you had dislocations before or suspect that you have issues with your shoulder? Get evaluated and better understand the condition of your shoulder Click here to book an appointment with our orthopedic specialist.
Rehabilitation is better managed with trained physiotherapists, and we have all of them here at Orthosports Medical Center. Click here to book an appointment with our physiotherapists.