The classification system for AC joint injuries includes six types.
- A type I injury is equivalent to a stretching of the AC ligament.
- A type II injury consists of tearing of the AC ligaments and stretching of the coracoclavicular ligaments.
- Complete disruption of the AC and coracoclavicular ligaments is seen in types III to VI.
Clinical Features: Patients complain of pain at the AC joint and will actively splint the injured shoulder. Ecchymosis may be present; however, an obvious deformity is not always seen. There is significant tenderness upon palpation of the AC joint.
Diagnosis: Standard radiographs should include anteroposterior (AP) and axillary lateral views of the shoulder.
- Type I injuries will appear normal.
- Type II injuries may show 0% to 50% displacement at the AC joint but no increase in the coracoclavicular interval.
- Types III to VI will demonstrate displacement at the AC joint and the clavicle will appear to be displaced superiorly (the acromion actually is rotated inferiorly) 50% to greater than 100% its width when compared with the normal side.
AC Joint Separation, Third Degree. A wide AC joint and the clavicle displaced from the acromion.
Management:
- Type I and type II injuries are treated with rest, ice, analgesics, and a simple sling until acute pain with movement is relieved.
- Treatment of type III injuries may be nonoperative or operative. However, these patients can be discharged from the emergency department in a sling without an emergent orthopedic consult.
- Types IV, V, and VI are treated operatively.
- Referral to a musculoskeletal specialist is essential for all AC joint injuries since many patients who initially appear to have minor injuries will have more obvious deformity after the swelling and pain have subsided.
Points To Remember:
1. The early AC joint stress radiograph can be negative due to splinting of the shoulder girdle muscles and does not add anything to the acute patient management.
2. Differentiating between types I and II versus types IV to VI is the goal of the ED physician, since the latter will require an emergency orthopedic consult.
ReplyDeleteI feel so excited today because it's just a year since I got my breakthrough from Herpes.I was diagnosed of HSV1 on the 12/4/2015 and latter i got affected with the HSV2. That was my 2nd outbreak after i lost my ex fiance that got me affected with the virus. I was so scared when he died and what i heard about the Herpes virus as he's deathly and such has no cure. I feel so pity and and a disgrace to my personality,in my career and my family to have been in with the deathly sickness, and that would makes my love ones siblings stay far from me. I was going to my regular church activities when i begin to hear testimonies of how people get cure online, i never gave it a thought till my cousin Stephanie who was affected with HIV told me, Lenny you need not to worry cos i met i man today online , i traditional herbal healer whom two of her friends confirmed he cure them with his herbal herbs that i should give it a try. I saw the interest in her and she did contact the herbal doctor again in my present, luckily for me he picked and show up himself, behold he was at about to attain to some patients that have came back with appreciation of how he cure them from Cancer, HIV, and off much too the herpes he cured an 18 years old daughter.
I was so happy that day, i wanted to be there but the distance was a barrier to me. I told him how the virus had eaten me up and and a truly believe there's cure for herpes. He told me me with assurance that my case wont be different and he had been curing lots of people With his herbal medicine and most people due contact him from the States and preperd the medicine and made use of the DHL to reach him.
Honestly speaking Dr. Akpu power his a great and gifted herbalist,His destined to herbs.
He made me do away with the medical prescription,the acyclovir (Zovirax), famciclovir(Famvir), and valacyclovir (valtrex). you don't know him because you haven't meet this man try and contact him yourself Dr. Akpu in Africa is popularly known in his City,and you can request for his address yourself. I'm so happy now cos,I and my cousin had been confirmed negative till date..the Lord is good in my life. Dr. Akpu sent me his herbal medicine that heal me too, 🙏 🙏 Dr. Akpu for giving me another life.
Contact Dr.akpu for all kids of sickness@
Dr.akpupowerherbscenter@gmail.com
I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their website at www.ultimatelifeclinic.com I can breath much better and It feels comfortable!
ReplyDelete