Dr. Carlos Rebollón
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Acromioclavicular dislocation is one of the most common traumatic acromioclavicular injuries seen in a shoulder specialist’s office.
To facilitate understanding of the topic, let’s start by defining in simple terms what acromioclavicular dislocation is. Acromioclavicular dislocation is an injury caused by a direct blow, a fall, or trauma, in which there is a complete or partial tearing of the ligaments that connect the clavicle to the scapula.
Diagnosis and Causes of Acromioclavicular Dislocation
The diagnosis of dislocation is the responsibility of the shoulder specialist, as they are the most qualified person to perform a physical examination of the shoulder joint and assess the extent of the injury through relevant radiological studies.
The tearing of ligaments is accompanied by the dislocation of the shoulder and clavicle. The more pronounced this displacement, the more severe the ligamentous injury, and the more limited the shoulder’s mobility. Acromioclavicular injuries are characterized by symptoms such as acute pain, tenderness to touch, functional limitation, and a slight deformity that alters the normal appearance of the shoulder joint.
Blunt shoulder impacts, motorcycle, bicycle, or skiing accidents, and regular participation in contact sports (rugby, American football, judo, etc.) are some of the main causes of acromioclavicular joint injuries.
Grades of Acromioclavicular Dislocation
Treatments for Acromioclavicular Dislocation
The choice of treatment method depends on the severity of the dislocation. Mild injuries, including types I, II, and III, often improve with conservative treatment (rest, bracing, etc.). However, individuals with type IV, V, or VI acromioclavicular dislocations typically require surgical treatment.
Standard conservative treatment for mild injuries includes pain relievers, anti-inflammatories, and the use of a brace or sling to keep the shoulder immobilized for several weeks. Additionally, the doctor may recommend progressive mobility exercises to maintain joint function and prevent muscle atrophy.
Physical Therapy for Acromioclavicular Dislocation
Physiotherapy support can be a valuable ally in overcoming acromioclavicular joint dislocations, especially when the physiotherapist includes isometric shoulder exercises. These exercises help manage pain, strengthen muscles, increase shoulder mobility, and minimize the risk of further injuries.
Acromioclavicular Dislocation Surgery
Surgery is recommended for patients with significant clavicular displacement, and chronic cases may require a tendon graft. This surgical intervention can be performed as an open procedure or through arthroscopy. In both cases, the shoulder specialist must have the knowledge and expertise to perform acromioclavicular reconstruction techniques and achieve successful results.
Symptoms of Acromioclavicular Dislocation
Although the symptoms of acromioclavicular dislocation can vary depending on the severity of the injury, here are some of the most common clinical manifestations:
At the time of the injury, the person will experience sudden and intense pain.
The affected joint may become swollen and red.
The acromioclavicular joint will be sensitive to touch and pressure.
In more severe cases, there may be an obvious deformity in the joint due to abnormal clavicle displacement.
There may be limited range of motion in the affected shoulder.
The patient may experience weakness in the shoulder and difficulty performing activities that require strength.
Acromioclavicular dislocation can be caused by various risk factors, including:
Participation in contact sports or sports involving sudden shoulder movements, such as rugby, American football, or hockey, can increase the risk of acromioclavicular dislocation.
A direct blow to the shoulder caused by a fall or strong impact can lead to acromioclavicular dislocation.
Lack of strength in the muscles surrounding the acromioclavicular joint, or an imbalance among the shoulder muscles, can increase the risk of dislocation.
As we age, joint tissues can weaken and become more prone to injuries, including acromioclavicular dislocation.
If you have had an acromioclavicular dislocation in the past, you may be at greater risk of experiencing future dislocations in the same joint.
Some individuals have clavicle anatomy that makes them more susceptible to acromioclavicular dislocations.
FAQ - ACROMIOCLAVICULAR DISLOCATION
In this section, we briefly answer some of the most common questions related to the topic…
Recovery from a mild acromioclavicular dislocation can take around 8 weeks, even less time for type I or II injuries. In complex cases, patients may be able to resume basic activities within an estimated 2 months, but a minimum of about 6 months is typically required to return to sports activities.
In acromioclavicular dislocation, other internal structures can be compromised. If not treated properly, it can lead to joint dysfunction, instability, and problems associated with ligaments, joint capsules, or muscles.
Arthroscopic surgery for acromioclavicular dislocation (one of the most common methods today) typically lasts between 90 and 120 minutes. Most patients do not require hospitalization, so they can be discharged on the same day of surgery.