Reading
Berkshire
Harley Street
London
ACJ Dislocation
What?
The Acromio-Clavicular joint (ACJ) is where the collar bone meets the front edge of the shoulder blade. When the ligaments (CC -ligaments) are ruptured the collar bone separates.
Why?
An ACJ dislocation is caused by an injury usually a fall or direct blow onto the shoulder. These are usually high energy sporting injuries.
The Coraco-clavicuclar (CC) ligaments are strong ligaments that stabilise the clavicle (collar bone).
If these Ligaments are injured the collar bone separates moving in an upwards direction.
Who?
ACJ dislocations happen after blunt trauma. This car be dueto a fall or sports injury.
How?
DIAGNOSIS:
You will have either an obvious bump on the shoulder / collar bone or pain over that area after an injury.
An x ray will conform the diagnosis and help direct the treatment. Injuries are grading from I-VI increasing in severity.
TREATMENT:
Low grade ligament sprains (Grade I-II) are treated non- operatively with physiotherpy and occasional cortisone injections to help with pain.
Moderate disruption (Grade III) generally are managed non-operatively with physiotherapy but some patients may require surgical stabilisation due to persistent pain or weakness. This will be a joint decision between yourself and the surgeon.
High grade dislocations (Grade IV-VI) generally require surgical stabilisation.
SURGICAL TREATMENT:
Surgical stabilisation of the ACJ requires Reconstruction of the torn ligaments are performed using synthetic industrial-strength polyester fibre. These are strong ropes that can hold the collar bone down.
Me?
TREATMENT OPTIONS:
Treatment decision is guided by the severity (Grade) of injury and your symptoms.
For low grade sprains I recommend a course of physiotherapy.
For High grade dislocations I recommend surgery (ACJ Reconstruction).
Success rates are around 85-90% using the LARS reconstruction technique.
Risk of serious complications are less than 1% (Major nerve and vessel injury, infection). Failure rates are reported to be between 3-5%.
Surgery is Performed under General anaesthesia. Risks include heart attack, Stroke, Clots (less than 1%).