| Separated shoulder | |
|---|---|
| Other names | Acromioclavicular joint injury, acromioclavicular separation, AC joint separation, AC separation |
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| An Xray showing a separated shoulder. Notice the separation between the end of the collarbone and the scapula. | |
| Specialty | Orthopedics, emergency medicine |
| Symptoms | Pain, deformity, decreased range of motion[1][2] |
| Types | Type I, II, III, IV, V, VI[2] |
| Causes | Trauma such as a fall[2] |
| Risk factors | Contact sports[3] |
| Diagnostic method | Examination, X-rays[2] |
| Differential diagnosis | Dislocated shoulder, clavicle fracture[4] |
| Treatment | Type I and II: Sling and pain medication[2] Type III: Conservative management and surgery if still symptoms[2] Type IV, V, VI: Surgery[2] |
| Frequency | Relatively common[3] |
A separated shoulder, also known as acromioclavicular joint injury, is a common injury to the acromioclavicular joint.[2] The AC joint is located at the outer end of the clavicle where it attaches to the acromion of the scapula.[2] Symptoms include non-radiating pain which may make it difficult to move the shoulder. The presence of swelling or bruising and a deformity in the shoulder is also common depending on how severe the dislocation is.[2][1]
It is most commonly due to a fall onto the front and upper part of the shoulder when the arm is by the side.[2] They are classified as type I, II, III, IV, V, or VI with the higher the number the more severe the injury.[2] Diagnosis is typically based on physical examination and X-rays.[2] In type I and II injuries there is minimal deformity while in a type III injury the deformity resolves upon lifting the arm upwards.[2] In type IV, V, and VI the deformity does not resolve with lifting the arm.[2]
Generally types I and II are treated without surgery, while type III may be treated with or without surgery, and types IV, V, and VI are treated with surgery.[3] For type I and II treatment is usually with a sling and pain medications for a week or two.[2] In type III injuries surgery is generally only done if symptoms remain following treatment without surgery.[2]
A separated shoulder is a common injury among those involved in sports, especially contact sports.[3] It makes up about half of shoulder injuries among those who play hockey, football, and rugby.[1] Those affected are typically 20 to 30 years old.[3] Males are more often affected than females.[3] The injury was initially classified in 1967 with the current classification from 1984.[1]
- ^ a b c d Willimon SC, Gaskill TR, Millett PJ (February 2011). "Acromioclavicular joint injuries: anatomy, diagnosis, and treatment". The Physician and Sportsmedicine. 39 (1): 116–22. doi:10.3810/psm.2011.02.1869. PMID 21378494. S2CID 10180712.
- ^ a b c d e f g h i j k l m n o p q Stucken C, Cohen SB (January 2015). "Management of acromioclavicular joint injuries". Orthopedic Clinics of North America. 46 (1): 57–66. doi:10.1016/j.ocl.2014.09.003. PMID 25435035.
- ^ a b c d e f Bishop JY, Kaeding C (December 2006). "Treatment of the acute traumatic acromioclavicular separation". Sports Medicine and Arthroscopy Review. 14 (4): 237–45. doi:10.1097/01.jsa.0000212330.32969.6e. PMID 17135974. S2CID 7806559.
- ^ Heckman J, Agarwal A, Schenck RC (2013). Current Orthopedic diagnosis & treatment. Current Medicine Group. p. 4. ISBN 9781461311072. Archived from the original on 2017-10-12.