Acromioclavicular joint injury - Revision history

Jonrako: /* Workup */

2021-07-28T19:58:16Z

Workup

← Older revision		Revision as of 19:58, 28 July 2021
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	===Workup===		===Workup===
	[[File:AC Separation XRAY (enhanced).png\|thumb\|]]		[[File:AC Separation XRAY (enhanced).png\|thumb\|]]
			[[File:AC Type III.JPG\|thumb]]
	*AP shoulder (highly consider comparison view)		*AP shoulder (highly consider comparison view)
	**AC joint		**AC joint

Blsimpso: /* Disposition */

2021-07-15T01:52:41Z

Disposition

← Older revision		Revision as of 01:52, 15 July 2021
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	==Disposition==		==Disposition==
	*~~Generally outpatient~~, ~~unless neurovascular compromise~~		*'''Admission Criteria'''
			**Neurovascular compromise
			**Open or unstable fractures
			**Admission for operative repair may be needed for Types IV, V, and VI
			*'''Discharge Criteria'''
			**Type I/Type II may be discharged with orthopedic follow-up
			**Type III may be discharged with urgent orthopedic follow-up

	==See Also==		==See Also==

Blsimpso: /* Background */

2021-07-15T01:29:35Z

Background

← Older revision		Revision as of 01:29, 15 July 2021
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	[[File:Right shoulder with AC Ligaments.jpg\|thumb\|Right shoulder anatomy with AC Ligaments.]]		[[File:Right shoulder with AC Ligaments.jpg\|thumb\|Right shoulder anatomy with AC Ligaments.]]
	*Occurs via direct trauma to the adducted shoulder		*Occurs via direct trauma to the adducted shoulder
			*Accounts for 40% of all shoulder injuries and 10% of all injuries in collision sports (football, hockey, etc.)<ref>Sirin E, Aydin N, Mert Topkar O. Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures. EFORT Open Rev. 2018;3(7):426-433. Published 2018 Jul 17. doi:10.1302/2058-5241.3.170027</ref>
	*Acromioclavicular (AC) and coracoclavicular (CC) ligaments may be affected		*Acromioclavicular (AC) and coracoclavicular (CC) ligaments may be affected
	*Routine use of stress radiographs is controversial (low yield)		*Routine use of stress radiographs is controversial (low yield)

Rossdonaldson1: /* Management */

2020-06-13T22:02:48Z

Management

← Older revision		Revision as of 22:02, 13 June 2020
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	==Management==		==Management==
	===Type 1===		===Type I===
	*Rest, ice, [[sling]]		*Rest, ice, [[sling]]
	*ROM and strengthening exercises as soon as tolerated		*ROM and strengthening exercises as soon as tolerated
	*Return to sport or work is limited only by pain		*Return to sport or work is limited only by pain

	===Type 2===		===Type II===
	*Rest, ice, [[sling]] x 3-7 days		*Rest, ice, [[sling]] x 3-7 days
	*ROM and strenghtnening exercises as soon as tolerated		*ROM and strenghtnening exercises as soon as tolerated
	*Return to sport or work once full ROM and strength are regained		*Return to sport or work once full ROM and strength are regained

	===Type 3===		===Type III===
	*Rest, ice, [[sling]] x2-3 weeks		*Rest, ice, [[sling]] x2-3 weeks
	*ROM and strengthening exercises as soon as tolerated		*ROM and strengthening exercises as soon as tolerated
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	*Ortho consultation within 1 week		*Ortho consultation within 1 week

	===Types 4-6===		===Types IV-VI===
	*Require orthopedic evaluation; emergent if neurovascular compromise exists		*Require orthopedic evaluation; emergent if neurovascular compromise exists
	*Generally operative		*Generally operative

Rossdonaldson1: /* Diagnosis */

2020-06-13T22:02:20Z

Diagnosis

← Older revision		Revision as of 22:02, 13 June 2020
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	\| align="center" style="background:#f0f0f0;"\|'''Image'''		\| align="center" style="background:#f0f0f0;"\|'''Image'''
	\|-		\|-
	\| '''Type 1'''\|\|		\| '''Type I'''\|\|
	*AC ligament sprain		*AC ligament sprain
	*AC joint intact		*AC joint intact
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	[[File:Classification type 1 of AC separation.png\|120px]]		[[File:Classification type 1 of AC separation.png\|120px]]
	\|-		\|-
	\| '''Type 2'''		\| '''Type II'''
	\|\|		\|\|
	*AC ligament torn		*AC ligament torn
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	[[File:Classification type 2 of AC separation.png\|120px]]		[[File:Classification type 2 of AC separation.png\|120px]]
	\|-		\|-
	\| '''Type 3'''\|\|		\| '''Type III'''\|\|
	*AC and CC ligaments torn		*AC and CC ligaments torn
	*Complete dislocation of the joint		*Complete dislocation of the joint
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	[[File:Classification type 2 of AC separation.png\|120px]]		[[File:Classification type 2 of AC separation.png\|120px]]
	\|-		\|-
	\| '''Type 4'''\|\|		\| '''Type IV'''\|\|
	*Complete dislocation with posterior displacement of distal clavicle in/through trapezius		*Complete dislocation with posterior displacement of distal clavicle in/through trapezius
	\|\|		\|\|
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	[[File:Classification type 4 of AC separation.png\|120px]]		[[File:Classification type 4 of AC separation.png\|120px]]
	\|-		\|-
	\| '''Type 5'''		\| '''Type V'''
	\|\|		\|\|
	*More severe form of type III injury		*More severe form of type III injury
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	[[File:Classification type 5 of AC separation.png\|120px]]		[[File:Classification type 5 of AC separation.png\|120px]]
	\|-		\|-
	\| '''Type 6'''		\| '''Type VI'''
	\|\|		\|\|
	*Complete dislocation with clavicle displaced inferiorly		*Complete dislocation with clavicle displaced inferiorly

Rossdonaldson1: /* Management */

2020-06-13T21:30:56Z

Management

← Older revision		Revision as of 21:30, 13 June 2020
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	==Management==		==Management==
	===Type 1===		===Type 1===
	*Rest, ice, sling		*Rest, ice, [[sling]]
	*ROM and strengthening exercises as soon as tolerated		*ROM and strengthening exercises as soon as tolerated
	*Return to sport or work is limited only by pain		*Return to sport or work is limited only by pain

	===Type 2===		===Type 2===
	*Rest, ice, sling x 3-7 days		*Rest, ice, [[sling]] x 3-7 days
	*ROM and strenghtnening exercises as soon as tolerated		*ROM and strenghtnening exercises as soon as tolerated
	*Return to sport or work once full ROM and strength are regained		*Return to sport or work once full ROM and strength are regained

	===Type 3===		===Type 3===
	*Rest, ice, sling x2-3 weeks		*Rest, ice, [[sling]] x2-3 weeks
	*ROM and strengthening exercises as soon as tolerated		*ROM and strengthening exercises as soon as tolerated
	*Return to sport or work 6-12 weeks following injury		*Return to sport or work 6-12 weeks following injury

Rossdonaldson1: /* Background */

2020-06-13T21:30:20Z

Background

← Older revision		Revision as of 21:30, 13 June 2020
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	[[File:Right shoulder with AC Ligaments.jpg\|thumb\|Right shoulder anatomy with AC Ligaments.]]		[[File:Right shoulder with AC Ligaments.jpg\|thumb\|Right shoulder anatomy with AC Ligaments.]]
	*Occurs via direct trauma to the adducted shoulder		*Occurs via direct trauma to the adducted shoulder
	*Acromioclavicular and coracoclavicular ligaments may be affected		*Acromioclavicular (AC) and coracoclavicular (CC) ligaments may be affected
	*Routine use of stress radiographs is controversial (low yield)		*Routine use of stress radiographs is controversial (low yield)

Rossdonaldson1: /* Background */

2020-06-13T21:26:53Z

Background

← Older revision		Revision as of 21:26, 13 June 2020
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	==Background==		==Background==
			[[File:Right shoulder with AC Ligaments.jpg\|thumb\|Right shoulder anatomy with AC Ligaments.]]
	*Occurs via direct trauma to the adducted shoulder		*Occurs via direct trauma to the adducted shoulder
	*Acromioclavicular and coracoclavicular ligaments may be affected		*Acromioclavicular and coracoclavicular ligaments may be affected

Rossdonaldson1: /* Clinical Features */

2020-06-13T21:24:27Z

Clinical Features

← Older revision		Revision as of 21:24, 13 June 2020
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	==Clinical Features==		==Clinical Features==
			[[File:Luxation acromioclaviculaire.jpeg\|thumb\|Acromion-clavicle injury. Note that the left shoulder is lower and the "piano key"; Screws on the radiography are a former trauma repair and unrelated to present trauma.]]
	*Tenderness directly over AC joint (with possible deformity)		*Tenderness directly over AC joint (with possible deformity)
	*AC compression test		*AC compression test

Rossdonaldson1: /* Evaluation */

2020-06-13T20:57:14Z

Evaluation

← Older revision		Revision as of 20:57, 13 June 2020
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	==Evaluation==		==Evaluation==
	===Workup===		===Workup===
	[[File:~~AC_Joint_Separation~~.~~jpg~~\|thumb\|~~AC joint separation~~]]		[[File:AC Separation XRAY (enhanced).png\|thumb\|]]
	*AP shoulder (highly consider comparison view)		*AP shoulder (highly consider comparison view)
	**AC joint		**AC joint
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	===Diagnosis===		===Diagnosis===
			[[File:AC_Joint_Separation.jpg\|thumb\|AC joint separation]]
	{\| {{table}}		{\| {{table}}
	\| align="center" style="background:#f0f0f0;"\|'''Classification'''		\| align="center" style="background:#f0f0f0;"\|'''Classification'''