New Procedure to Repair an AC Separation
A separated shoulder is usually the result of:
- a fall onto an outstretched hand (my separated shoulder occurred as the result of a fall while skiing)
- a direct impact to the shoulder (often seen in football, rugby, lacrosse, or any other contact sport / activity)
(photo used courtesy of Neil Rickards)
There is an new, outpatient procedure called the Mumford procedure for arthroscopic AC joint repair….full range of motion can be regained in day.
The Mumford Procedure
Shoulder Separations are Distinguished by Severity of the Injury
The following data is used courtesy of Wikipedia – Shoulder Separation
A Type I AC separation involves trauma to the ligaments that form the joint, but no severe tearing or fracture. It is commonly referred to as a sprain. Most doctors treat this type of dislocation with anti-inflammatory drugs, pain medication and the placement of the arm in a sling or an immobilizer.
A Type II AC separation involves complete tearing of the acromioclavicular ligament, as well as a sprain or partial tear of the coracoclavicular ligaments. This often causes a noticeable bump on the shoulder. By pressing on the sternal aspect of the clavicle you force the acromial end down, and by releasing, watch it pop back up (eliciting a piano key sign due to the tearing of the AC ligament). Severe pain and loss of movement are common. Treatment is typically an arm sling, bedrest, ice and heat therapy, and anti-inflammatory drugs. Most people recover full motion of the shoulder and arm within 6 to 8 weeks, often with the assistance of physical therapy.
In a Type III AC separation both acromioclavicular and coracoclavicular ligaments are torn. A significant bump is formed by the lateral end of the clavicle. This bump is permanent. The clavicle can be moved in and out of place on the shoulder. It may take 12 weeks to heal, and physical therapy can be beneficial. It may take even longer for the shoulder strength to approach feeling normal. The injured shoulder may not be able to take the abuse that it could previously, but for most purposes it will be quite usable and sufficient. However, there still is controversy as to whether or not surgery may be necessary for optimal shoulder use in sport.
This is a type III injury with avulsion of the coracoclavicular ligament from the clavicle, with the distal clavicle displaced posteriorly into or through the trapezius. This injury is generally acknowledged to require surgery.
This is type III but with exaggeration of the vertical displacement of the clavicle from the scapula. This injury generally requires surgery.
This is type III with inferior dislocation of the lateral end of the clavicle below the coracoid. It is extremely rare and generally only involved with motor vehicle collisions. This requires surgery.
More Shoulder Separation Information
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