Acromioclavicular Dislocation

Acromioclavicular (AC) dislocation, commonly referred to as a shoulder separation, occurs when the clavicle (collarbone) separates from the scapula (shoulder blade) at the acromioclavicular joint. This injury is often the result of a fall directly onto the shoulder, such as from a sports injury, bicycle accident, or fall from height.

Types of AC dislocation

AC dislocations are classified into six types (Type I to Type VI), depending on the severity of the injury:
– Type I: A mild injury where the AC ligament is stretched or partially torn, but the bones remain in place.
– Type II: A partial dislocation, with some tearing of the AC ligament. The clavicle may be slightly displaced.

– Type III: A complete separation, where both the AC and coracoclavicular (CC) ligaments are torn, causing visible displacement of the clavicle.
– Type IV-VI: More severe dislocations involving significant displacement, including posterior or superior displacement, which may require surgical intervention.

Symptoms

– Pain at the top of the shoulder
– Swelling and bruising
– Visible deformity or “bump” at the AC joint (more common in severe cases)

– Reduced shoulder range of motion
– Weakness when lifting the arm

Diagnosis

Diagnosis typically involves a physical examination

and imaging studies like X-rays to confirm the degree of dislocation and rule out fractures.

Treatment

– Non-surgical: For mild to moderate dislocations (Type I-II, sometimes Type III), conservative management includes rest, ice, anti-inflammatory medications, physical therapy, and use of a sling to immobilize the shoulder.

– Surgical: Severe dislocations (Type IV-VI, and sometimes Type III) may require surgical repair or reconstruction of the ligaments to restore function and prevent long-term instability.

Recovery time can vary depending on the severity, with mild injuries recovering in a few weeks, while severe cases requiring surgery may take several months to heal fully. Physical therapy plays a crucial role in regaining shoulder strength and mobility.

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