AC Joint stabilisation

Acromioclavicular (AC) joint stabilisation is the process used to fix collarbone dislocation.

AC Joint stabilisation

Acromioclavicular (AC) joint stabilisation is the process used to fix collarbone dislocation.

AC Joint Stabilisation

What is AC joint separation?

AC joint separation is the dislocation of the clavicle from the scapula. Trauma to the shoulder – caused, for example, by a fall directly onto the joint or onto the outstretched hand can result in torn ligaments. There are several types of AC joint injury classed by severity, ranging from a sprain that heals within weeks to a complete tear. The best treatment option for the condition depends on the extent of your injury.

The symptoms of AC joint separation vary depending on the severity of the injury, ranging from a small deformity on the shoulder to a bone that protrudes from the skin. The most common symptoms of AC joint separation include pain and swelling at the top of the shoulder, which can form a visible bump or bruise on the shoulder. Limited or lost range of motion in the shoulder and arm is also common, as is weakness and discomfort.

The AC joint compression test is the best way to determine whether your AC joint has been separated. If you experience significant pain when another person presses on the front and back sides of your shoulder joint, you should seek immediate medical attention. A doctor will be able to feel for signs of separation in the bones and soft tissue, and once the separation is confirmed, clinical examination will determine the severity of the injury. The examination process generally involves an X-ray taken while holding a weight.

The most appropriate treatment for separated AC joints depends on the severity of the separation. In mild cases, the injury may heal on its own after resting in a sling for a few weeks. Then, a course of physical therapy for the neck and shoulders is recommended. Severe separations generally require a more invasive surgical procedure in which the damaged end of the collarbone is removed and replaced with an artificial ligament.

Although AC joint ligaments never heal completely, full recovery is likely with the right treatment. Most AC injuries do not require surgery. Mild cases of joint separation generally respond well to stabilisation in a sling followed by a course of physiotherapy. Pain resolve in a 1-2 weeks. However, if after two months, lifting your arms over the head still causes pain, surgery may be necessary. 

Whilst the majority of people who undergo shoulder surgery do well and are very happy with their function and result, there are risks which are specific to shoulder surgery in addition to the general risks of surgery. This includes deep infection, injury to the nerves tendons or blood vessels close to the surgical field which may require further surgery, stiffness or developing a frozen shoulder, ongoing pain, fracture of the bones and abnormal pain responses such as Chronic Regional Pain Syndrome (CRPS).

Most of these risks are low and less than 5 %, but it is important to be aware of these risks before consenting to surgery. There are also risks relating to the specific type of shoulder surgery that you are having which Dr Cheriachan will discuss with you in detail during your consultation.

You will need to wear a sling 24 hours a day for at least three weeks, keeping the arm still and close to the body. Due to the lack of movement, it’s also important that you keep your armpit dry to avoid sweat rash or infection. After three weeks, you will gradually increase movement in your arm as the body adjusts to the surgical graft until the sling can be removed at approximately six weeks, assuming the injury is healing well.

Preparing for your visit

Dr Cheriachan consults from Norwest on Wednesdays and Blacktown on Mondays and Thursdays.

Your first visit will be used to carefully assess your condition as well as gathering all related health information. It is important that you bring all relevant documents including scans and x-rays. We also ask that you wear clothing that allows freedom of movement as your visit will include a physical examination.