Flashcards in Acromioclavicular Joint Injuries Deck (23)
What makes the AC joint vulnerable to injury from direct trauma?
What are AC joint injuries sometimes referred to as?
Shoulder sprains or separations
The AC ligaments primarily resist what types of forces?
anterior and posterior
The coracoclavicular ligaments primarily resist what types of forces?
superior and axial
The AC joint is involved in _-_% of shoulder girdle injuries
How do AC joint injuries tend to occur?
A direct blow or falling onto a adducted shoulder
How many types of AC joint injury classifications are there?
Describe a type I AC joint injury
The AC joint is still intact and this type of injury is referred to as an AC ligament strain
What will the x-ray findings be for a type I AC joint injury?
Describe a type II AC joint injury
The AC ligament is torn, but the coracoclavicualr ligament is intact which results in subluxation of the AC joint.
What will the x-ray findings be for a type II AC joint injury?
Slight widening of the AC joint, the clavicle will be elevated 25-50% above the acromion, and the coracoclavicular interspace will be slightly widened
Describe a type III AC joint injury
Both the AC and CC ligaments are torn which results in complete dislocation of the AC joint
What will the x-ray findings be for a type III AC joint injury?
AC joint dislocated 100% and the coracoclavicular interspace widened 25-100%
Describe a type IV AC joint injury
There is complete dislocation with posterior displacement of the distal clavicle into or through the trapezius muscle
What will the x-ray findings be for a type IV AC joint injury?
May appear similar to type II and II, however the axillary radiograph will demonstrate posterior dislocation
Describe a type V AC joint injury
There is superior dislocation of the joint 1-3 times the size of the normal spacing, which increases the CC ligament distance 2-3 times normal and causes disruption of the deltotrapezial fascia
What will the x-ray findings be for a type V AC joint injury?
AC joint dislocated and generally 200-300% disparity of the coracoclavicular interspace compared to the normal shoulder
Describe a type VI AC joint injury
There is complete dislocation of the AC joint with inferior displacement of the distal clavicle into a subacromial or subcoracoid position
What will the x-ray findings be for a type VI AC joint injury?
AC joint dislocation and the clavicle displaced inferiorly
What x-ray view is most useful to diagnose AC joint injuries?
How are type I and II injuries treated?
Rest, ice, analgesics, and immobilization, followed by early range of motion exercises
How are type III injuries treated?
Treatment is controversial, the trend over the last several decades for the initial treatment of type III injuries has moved from operative to nonoperative in the majority of cases