There are few complications and most patients are very satisfied with the result. There is always a possibility of infection but it is rare.
Occasionally a patient may have some fatigue or pain with extreme lifting or with exercises if the shoulder is not in shape.
However, most patients are very satisfied with the surgery and can be more active than before surgery. When the AC joint is separated, it means that the ligaments are torn and the collarbone no longer lines up with the acromion. Ligaments are tough, sinewy tissues that act like tethers to hold the bones together. When those ligaments are stretched or torn they can be very painful. The injury to the ligaments in an AC separation can be mild to severe.
The injuries are graded depending upon which ligaments are torn and how badly they are torn. A grade 1 injury is where the least damage is done and only the joint itself is injured. A grade 2 injury consists of damage to the ligaments at the AC joint and also to the other ligaments that stabilize the joint.
This second set of ligaments attach the collarbone to the part of the shoulder blade called the coracoid. These ligaments are called the coracoclavicular ligaments. In a grade 2 injury, these coracoclavicular ligaments are only stretched but not entirely torn. The collarbone may not line up with the acromion if these are stretched and results in a lump at the AC joint. In a grade 3 injury, the coracoclavicular ligaments are completely torn and the collarbone is no longer tethered to the shoulder blade.
As a result the collarbone no longer lines up with the acromion and there is a deformity at the joint. These can be very painful injuries and the initial treatment is to decrease the pain. This is best accomplished by immobilizing the arm in a sling, placing an ice pack to the shoulder for 20 to 30 minutes as often as every two hours and using pain medication. The pain is usually proportional to the severity of the separation. As the pain starts to subside, it is important to begin moving the fingers, wrist and elbow to prevent stiffness.
Next it is important to begin shoulder motion to prevent a stiff or "frozen" shoulder. When and how much to move the shoulder should be done at the direction of your physician, physical therapist or trainer. Usually as the pain is decreasing you will find you can move it more, and this will not damage or hinder the healing process. The length of time needed to regain full motion and function depends upon the severity or grade of the injury.
A grade 1 takes 10 to 14 days, whereas a grade 3 takes six to eight weeks. A grade 2 takes somewhere in between. The good news is that the majority of grade 1, 2 and 3 injuries do not need surgery. Even the grade 3 injuries usually allow a return to full activity with few restrictions.
There are some surgeons who recommend surgical treatment for high-caliber athletes who throw a baseball for a living, but the vast majority of people do not need surgery for this condition. There are rare variations of this injury where the collarbone is higher than usual and almost sticking through the skin. Shoulder separations are common, especially in active young adults. Your shoulder blade connects to your upper arm bone and to your collarbone with ligaments. The highest point of your shoulder blade is called the acromion.
Two AC ligaments attach the acromion to your collarbone. This is the AC joint. Another ligament, the coracoclavicular CC ligament, connects part of your shoulder blade to your collarbone. Injury may damage these ligaments around your joint. If the damage is severe, the collarbone and shoulder blade pull apart causing a shoulder separation. Your shoulder blade may move downward from the weight of your arm. Healthcare providers rate injuries to the AC joint based on how severe they are.
A type I injury is the most mild. A type VI injury is the most severe. In a type I injury, the AC ligaments are only partially torn, but the bones remain in place. Your collarbone and shoulder blade are slightly out of line. With more severe injuries, the bones pull out of position even more. There may also be damage to other tissues around the area. Different types of shoulder injuries can lead to shoulder separation.
Often, the injury happens when you fall directly on the top of your shoulder, when your arm is close to your body. A direct blow to your shoulder, or falling onto an outstretched hand, can also cause the injury. Car accidents and sports injuries are potential causes. These symptoms vary quite a bit depending on how severe the injury is.
A type I injury may cause only slight pain, mild swelling, and a normal-appearing shoulder and arm. A slightly more severe injury might cause greater pain and swelling, though the arm and shoulder may still appear mostly normal.
With a more severe injury, the top part of the shoulder may look deformed, and the pain and swelling may be more intense. The collarbone may go far above the acromion of your shoulder blade.
There may also be bruising of the area. In some cases, the collarbone may even poke out through the skin. Your healthcare provider will ask about your health history and give you a physical exam. They will look at your shoulder and arm and press on your AC joint, which may hurt.
More severe shoulder separation injuries are easy to diagnose with just a physical exam. This is because the shoulder will clearly look deformed. In any case, you will likely need an X-ray of your joint. This can help give more information about how severe your injury is. During the exam or X-ray, your healthcare provider might have you hold a weight on the injured side. This can make a deformity more obvious.
Your treatment will depend on the severity of your injury, and may include:. Your healthcare provider may show you special exercises to help rebuild your strength, flexibility, and range of motion as you heal.
If your injury is more severe, you may need surgery. Some type III injuries may also need surgery as well, especially for athletes. Your healthcare provider may first want to see if your AC joint heals on its own before trying surgery. Surgeons have a number of ways to bring your collarbone back into alignment with the scapula. Usually there is a protuberance or bump in this area, which can be quite large in some people normally.
This joint, like most joints in the body, has a cartilage disk or meniscus inside and the ends of the bones are covered with cartilage.
The joint is held together by a capsule, and the clavicle is held in the proper position by two heavy ligaments called coracoclavicular ligaments. A shoulder separation is an injury to the joint where the shoulder blade scapula meets the collarbone clavicle. This joint is known as the acromioclavicular joint or AC joint and is located at the tip of the shoulder.
These two bones are held together by tough, sinewy tissues—ligaments—that tie the bones together. One group of ligaments envelope the joint to form a capsule that covers the joint; these ligaments are termed the acromioclavicular ligaments. Another set of ligaments stabilize the shoulder by holding the clavicle in place by attaching it to a bony knob on the surface of the shoulder blade called the coracoid process.
These ligaments are called the coracoclavicular ligaments. There is a pad of cartilage in the joint between the two bones that allows them to move on each other. When these ligaments are stretched strained or torn, either partially or completely, the outer end of the collarbone may slip out of place, keeping it from its proper fit with the shoulder blade.
Acromioclavicular separation or strain is another term for shoulder separation. A shoulder separation differs from a shoulder dislocation. In a shoulder dislocation the injury occurs at the ball and socket joint where the upper arm bone humerus becomes dislocated from the shoulder blade. Shoulder separation injuries typically are classified into grades I, II, or III, depending on the severity of the separation of the collarbone from the shoulder blade.
Grade I: the ligaments are bruised or strained but there is no actual separation at the AC joint. Grade II: may involve a partial tear in the acromioclavicular ligaments around the joint, the coracoclavicular ligaments are stretched, and there is a slight separation of the shoulder blade from the collarbone.
The cartilage in the AC joint may also be injured. A lump may appear at the AC joint. Grade III: separation occurs when the acromioclavicular ligaments and the coracoclavicular ligaments are torn, the collarbone is no longer attached to the shoulder blade, and a prominent deformity or bump may appear at the joint.
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