. . The following is a listing and brief description of the classifications Types I – VI of AC joint injuries :
TYPE I ….. Tenderness of the AC joint with no significant disruption of the AC or CC ligaments. This is simply a sprain or contusion of the AC joint.
TYPE II ….. Complete tear of the AC ligament and partial tear of the CC ligament.
TYPE III ….. Complete tear of the AC and CC ligaments.
TYPE IV ….Type III plus lateral aspect of clavicle displaced posteriorly
TYPE V ….. Type III plus lateral aspect of clavicle displaced posteriorly and puncturing the trapezius muscle.
TYPE VI ….. Type III plus lateral aspect of clavicle displaced inferiorly and lodged below the coracoids. .
Illustration 53 AC Joints With Weights
. . Classification and treatment guidelines :
Type I, II……… Treatment usually consists of arm sling, ice, anti-inflammatory drugs, physical therapy.
Type III………. Conservative treatment might be adequate but sometimes requires surgery.
Type IV, V, VI………. Most often will require surgery.
In all cases— treatment, consultation and context of other injuries must be taken into account before final decision regarding disposition is made.
AC JOINT PEARLS :
The most important clue re AC joint separation is the clinical finding of swelling and tenderness over the joint. Finger-walk the clavicle medial to lateral until you reach the acromion of the scapula—this is the AC joint. · Be sure and get a radiograph of the opposite side for comparison. · When looking for AC joint separation, please be aware that a special view of the AC joint is available –ask for this view and/or ask for a special view with and without weights ( this might accentuate the separation ). See Illustrration 53 · If indicated, a next level study would be the CT scan or MRI. · If clinically indicated, consider orthopedic consult.