Acromio-Clavicular Joint (ACJ) Dislocation

 

Mechanism/Injury:              

Traumatic Injury to shoulder

Fall on to the point of the shoulder- fall from bike, tackled during rugby

Shoulder blade and arm driven down away from end of clavicle

6 types:   1 and 2- almost always settle with conservative treatment

                3- approx. 65-75% settle with conservative treatment

                4- collar bone moves backwards and usually requires surgery

                5 and 6- rare and severe injuries often complicated with other injuries

                                               

Symptoms:                           

Prominent mobile lump at the end of the collar bone

Pain felt at the end of the collar bone

Pain down into upper arm on raising arm forwards or sideways

Pain on top of the shoulder on using the arm across the front of the body

Pain on lying on arm in bed, disturbed sleep

 

Investigations:                     

X-Ray, Ultrasound scan, MRI scan

 

Treatment options:             

Pain killers

Physiotherapy- for types 1 to 3

ACJ Reconstruction/Lockdown- some type 3.Most type 4s