Acromioclavicular Joint Injury, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Acromioclavicular Joint Injury, Diagnosis and Treatment and Related Diseases

The acromioclavicular (AC) joint injury is an injury to the acromioclavicular (AC) joint with disruption of the AC ligaments with or without coracoclavicular (CC) ligament disruption.

Acromioclavicular Joint Injury is a frequent injury among athletes and young persons.

AC injuries are often seen after sporting events, car accidents, falls from a bicycle, and other sports-related activities (e.g., skiing).

AC joint injuries are responsible for more than 40% of all shoulder injuries and nearly 10% of all injuries in collision sports such as football, lacrosse, and ice hockey

Acromioclavicular injuries may be linked with a fractured clavicle, impingement syndromes, and more rarely neurovascular injuries.

The most frequent mechanism of injury is direct trauma to the lateral shoulder or acromion process with the arm in adduction.

Falling on an outstretched hand or elbow may also cause AC joint separation.

A direct blow to the shoulder may cause AC joint injury, often sustained while falling onto the shoulder

There is pain normally over AC joint which can also be extended to the trapezius

Patients with an AC joint injury normally manifest with shoulder pain, normally superior-anterior in location, and will depict a mechanism of injury indicating this type of injury.

They may depict pain spreading to the neck or shoulder which is often worse with movement or when they attempt to sleep on the affected shoulder.

On physical examination, the doctor may notice swelling, bruising, or a deformity of the AC joint depending on the degree of injury.

The patient will feel tenderness at that location.

The doctor can evaluate the stability of the AC joint with anterior-posterior mobility (acromioclavicular ligament) and vertical mobility (coracoclavicular ligaments).

Standard x-rays are sufficient to make a diagnosis of acromioclavicular joint injury and should be used to assess for other causes of traumatic shoulder pain.

AC joint injuries may not always be evident on normal radiographic views (anteroposterior AP, lateral).

Additional X-rays views are:
1. The zanca view, an AP view done by tilting the beam 10 to 15 degrees cranial, and
2. Bilateral AP views to compare displacement to the contra-lateral shoulder.

Weighted stress views may be done to assess the displacement of the joint when the diagnosis is not certain on standard AP views.

It is important to appraise the entire clavicle for possible fracture or sterno-clavicular injury as well as do a full neurovascular examination on the affected extremity.

Non-operative treatment comprises brief sling, immobilization, rest, ice, physical therapy

Indications for non-operative treatment are:
1. Type I and II
2. Type III in most persons
Good results are obtained when the clavicle is displaced < 2cm

Surgical treatment is needed for:
1. Acute type IV, V or VI injuries
Recent studies indicate no disparity in functional outcomes between operative and non-operative interventions for high grade injuries
2. Acute type III injuries in laborers, elite athletes, patients with cosmetic worries
3. Chronic type III injuries that failed non-operative treatment

Acute injuries were treated with ORIF (open reduction internal fixation) and chronic injuries were treated with CC ligament reconstruction

New studies have shown no disparity in outcomes in types III injuries treated surgically after 6 weeks non-operative treatment versus immediate surgery

TABLE OF CONTENT
Introduction
Chapter 1 Acromioclavicular Joint Injury
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Floating Shoulder
Chapter 8 Distal Clavicle Osteolysis
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Jan 7, 2020
• ISBN: 9780463980781

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Acromioclavicular Joint Injury,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2019 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Acromioclavicular Joint Injury, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Acromioclavicular Joint Injury)

This e-Book is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Acromioclavicular Joint Injury

What is Acromioclavicular Joint Injury?

The acromioclavicular (AC) joint injury is an injury to the acromioclavicular (AC) joint with disruption of the AC ligaments with or without coracoclavicular (CC) ligament disruption.

Acromioclavicular Joint Injury is a frequent injury among athletes and young persons.

Incidence

AC injuries are often seen after sporting events, car accidents, falls from a bicycle, and other sports-related activities (e.g., skiing).

AC joint injuries are responsible for more than 40% of all shoulder injuries and nearly 10% of all injuries in collision sports such as football, lacrosse, and ice hockey

It is a frequent injury making up 9% of shoulder girdle injuries

It is more frequent in males and athletes

What is the cause of Acromioclavicular Joint Injury?

Cause

The AC joint is a di-arthrodial joint depicted by the lateral process of the clavicle articulating with the acromion process as it protrudes anteriorly off the scapula.

The joint is mainly stabilized by the acromioclavicular ligament providing horizontal stability across the joint.

Supporting structures are 2 coracoclavicular ligaments (trapezoid and conoid ligaments), which supply vertical stability, and the coracoacromial ligament.

These ligaments can be injured, and if the injury is serious, one or more of these ligaments can be torn.

The acromioclavicular joint can also be disrupted medically and radiographically.

Mild injuries are not linked with any significant morbidity but severe injuries can cause significant loss of strength and function