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AC Joint Separation

An Acromioclavicular Joint Separation or AC Joint Separation or AC Joint Sprain or simply Shoulder Separation is a common shoulder injury among active people like athletes. In this injury, the clavicle (collar bone) separates from the scapula (shoulder blade). The clavicle and scapula together form the socket that holds the ball of the upper arm bone. AC Joint Separation is generally caused due to a direct injury like a fall or a blow to that spot. It is a common sports injury, frequently seen in football and hockey players and cyclists.

Classification of AC Joint Injuries

AC Joint injuries range from very mild (Grade 1) to a severe injury (Grade 6). AC Joint Dislocations are classified by Tossy (3-grade classification), Allman (3-grade classification) and Rockwood (6-grade classification). Rockwood’s classification is the one most commonly used.

Classification Description
Grade 1 AC Joint Strain
Grade 2 AC disrupted, CC Strain
Grade 3 AC and CC disrupted
Grade 4 Distal Clavicle positioned posterior to acromion
Grade 5 Subcutaneous distal clavicle
Grade 6 Distal clavicle positioned inferior to coracoid
Acromioclavicular (AC) Joint Separation
Rockwood classification of AC Joint Separation

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Symptoms of AC Joint Separation

Symptoms include pain and swelling on the shoulder. The pain generally increases when trying to make overhead movements or trying to sleep on the affected side. In some cases, there will be limited movement in the shoulder area and in some severe cases, a lump will be formed on top of the shoulder joint.

Diagnosis of Shoulder Separation

Your doctor might diagnose AC joint separation by any or all of the following methods: Medical history, Physical examination, X-ray or some tests to evaluate the pain and the range of motion.

Treatment of Acromioclavicular Joint Separation

Most AC Joint injuries don’t need surgery however in some severe cases surgery is required. People with low grade AC joint injuries will be put on standard medical treatment which includes:

Using Sling
Anti-inflammatory Drugs
Physical Therapy

Such injuries (generally Grade 1 to 3) will be healed in two to three weeks.

People with high grade AC Joint injuries (generally Grade 4 to 6 and in some cases Grade 3) will be required to undergo surgery in cases where standard non-surgical methods does not help relieve the pain and swelling. A surgeon will try to put the clavicle back to scapula. For this, a variety of implants are available as per the need of the patient. These surgeries are generally performed using Arthroscopy, which is less painful and with better recovery time. However, in some cases open surgical methods are used. Suitable rehabilitation will be required post-surgery including wearing of sling, medications and physio/occupational therapy.

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