X-Ray to know status of joint.
MRI to show status of Ligaments.
Type 1 to type 3 injuries are treated successfully with non-operative treatment that may include :
- Ice to reduce pain and swelling.
- Rest and a protective sling until pain subside.
- Anti-inflammatory medications.
This usually takes about 1-2 weeks
A rehabilitation program to restore normal motion and strength is begun as soon as tolerated with gentle exercises and progresses as healing allows.
Depending upon the grade of injury, most patients heal within 2 to 3 months without surgical intervention.
The patient is allowed to return to sports when there is full and painless range of motion, no more tenderness when the AC joint is touched and manual traction does not cause pain. This usually takes about 2 weeks for a grade I injury, 6 weeks for a grade II injury, and up to 12 weeks for a grade III injury.
» Operative Treatment
Surgery may be necessary for AC separations that do not respond well to non-operative treatment or type 4 to type 6 injuries.
If, after 2 to 3 months, pain continues in the AC joint with overhead activity or in contact sports, surgery may be necessary.These patients include:
- Young, active individuals (over the age of 13).
- Laborers whose jobs require heavy overhead work.
- Athletes in non-contact sports whose overhead movements are stressful and frequent.
A variety of surgical methods have been used to stabilize a separated AC joint. The surgical technique most often performed involves the reconstruction of the coracoclavicular ligaments and the excising (removal) of the distal (shoulder) end of the clavicle. Distal clavicle resection without the repair of the ligaments may lead to excessive rotation of the scapula. Reconstruction studies show that the AC joint can be adequately stabilized by :
- A fixation across the acromioclavicular space with pins or plates.
- Loop fixation from the clavicle to the coracoid process using synthetic materials.
- The most common reconstructive procedures of today use a screw or suture loop to stabilize the joint.
In a distal clavicle resection, about 10-15mm of the clavicle is removed through a two-inch incision above the joint. The AC ligament is then transferred from the bottom of the acromion into the cut end of the clavicle to replace the torn ligament.