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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

  • 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

 

Classification



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