Clavicle dislocation

ACROMIOCLAVICULAR JOINT DISLOCATION

It is the joint formed between the clavicle and the acromion. The lesions of the acromioclavicular joint occur after falling on the shoulder and can result injury with ligament complete rupture, when the dislocation of the acromioclavicular joint occur.

Clinical examination
Clinically the palpation produce intense tenderness and pain at the site of injury in the shoulder combined by deformation of the outer edge of the clavicle is displaced upward. Also observed painful limitation of motion of the shoulder.


The acromioclavicular joint dislocation - complete ligament rupture. The arrow shows the pathological diastasis between the clavicle and the acromion


Acromioclavicular joint dislocation right after fall of person on the ground with outstretched right upper end

Radiological examination

The radiological examination is the first choice in the investigation of the joint pathology after injury. 


Radiographs of the right shoulder of two different persons. The clavicle is shifted upward due to injury of the ligaments.

Many times complementary, CT scan of the affected area gives more information in relation to the dislocation and surrounding anatomical bone structures.


CT scan of the right shoulder highlighted clearly the upward displacement of the key relative to the acromion (arrow)

Computed tomography with three dimensional reconstruction (3D reconstruction) shows the complete three-dimensional image of the shoulder to fully understand the details of the injury.


CT-scan with 3D reconstruction.

CONSERVATIVE TREATMENT
THERAPY: 

The treatment of dislocation of the acromioclavicular joint depends on the severity of the injury. In subluxation of the acromioclavicular with partial rupture of joint ligament so there is no large shift of the clavicle upwards.
In this case, the injury treated conservatively with the upper end resting on a triangular bandage, until elimination of pain (which usually occurs in a week), when it begins physiotherapy shoulder.


Place the left arm in a triangular bandage

 

OPERATIVE TREATMENT
THERAPY: 

The complete rupture of the acromioclavicular joint ligaments leads to the appearance of dislocation of the clavicle bone that completely misses the anatomical continuity of the shoulder. The dislocation of the clavicle usually treated surgically. There are now modern surgical techniques to restore the clavicle in the anatomical position and stabilize it.

The goal of surgery is to restore the displacement clavicle and the patient return to social and professional activities as quickly as possible

The neglected dislocation of the acromioclavicular joint causes bad cosmetic result, particularly intense in women and has significant impact on the functioning of the shoulder especially in young patients, and athletes.
Elderly patients, no special requirements and simple cases of dislocation of the acromioclavicular joint can be treated conservatively with quite good results.

Restore and stabilize the clavicle to the anatomical position with a special implant


Tunnel in the clavicle to insert the specific implant (Tightrope, Arthrex USA)


A special implant stabilization the clavicle (red circle)


Postoperative X-ray in which the clavicle is back in anatomical position. The arrow shows the bone stabilization implant - Tightrope Arthrex USA-


Patient immediately after surgery. The deformation of the shoulder has been fully restored