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. 2000 Jul-Sep;35(3):261–267.

Acromioclavicular Joint Injuries

Gloria M Beim 1
PMCID: PMC1323387  PMID: 16558638

Abstract

Objective:

To discuss the anatomy and biomechanics of the acromioclavicular (AC) joint, along with the clinical evaluation and treatment of an athlete with an AC joint injury.

Data Sources:

I searched MEDLINE from 1970 through 1999 under the key words “acromioclavicular joint,” “clavicle,” “acromioclavicular separation,” and “acromioclavicular dislocation.” Knowledge base was an additional source.

Data Synthesis:

AC joint injury is common in athletes and a source of significant morbidity, particularly for athletes in overhead sports. Because this injury can masquerade as other shoulder conditions, the examiner must understand the anatomy and biomechanics of the shoulder in order to perform a systematic clinical evaluation and identify the injury.

Conclusions/Recommendations:

Careful attention to the clinical evaluation allows the clinician to categorize the athlete's AC joint injury and institute appropriate treatment in a timely fashion, thus permitting the athlete to return to sport as quickly and safely as possible.

Keywords: acromioclavicular ligaments, coracoclavicular ligaments, acromioclavicular joint separation, clavicle fracture, sternoclavicular dislocation, distal clavicle osteolysis, acromioclavicular joint degenerative disease

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barber F. A. Complete posterior acromioclavicular dislocation. A case report. Orthopedics. 1987 Mar;10(3):493–496. doi: 10.3928/0147-7447-19870301-16. [DOI] [PubMed] [Google Scholar]
  2. Bearden J. M., Hughston J. C., Whatley G. S. Acromioclavicular dislocation: method of treatment. J Sports Med. 1973;1(4):5–17. doi: 10.1177/036354657300100401. [DOI] [PubMed] [Google Scholar]
  3. Bearn J. G. Direct observations on the function of the capsule of the sternoclavicular joint in clavicular support. J Anat. 1967 Jan;101(Pt 1):159–170. [PMC free article] [PubMed] [Google Scholar]
  4. Bjerneld H., Hovelius L., Thorling J. Acromio-clavicular separations treated conservatively. A 5-year follow-up study. Acta Orthop Scand. 1983 Oct;54(5):743–745. doi: 10.3109/17453678308996622. [DOI] [PubMed] [Google Scholar]
  5. Bossart P. J., Joyce S. M., Manaster B. J., Packer S. M. Lack of efficacy of 'weighted' radiographs in diagnosing acute acromioclavicular separation. Ann Emerg Med. 1988 Jan;17(1):20–24. doi: 10.1016/s0196-0644(88)80497-9. [DOI] [PubMed] [Google Scholar]
  6. Cahill B. R. Osteolysis of the distal part of the clavicle in male athletes. J Bone Joint Surg Am. 1982 Sep;64(7):1053–1058. [PubMed] [Google Scholar]
  7. Dias J. J., Steingold R. F., Richardson R. A., Tesfayohannes B., Gregg P. J. The conservative treatment of acromioclavicular dislocation. Review after five years. J Bone Joint Surg Br. 1987 Nov;69(5):719–722. doi: 10.1302/0301-620X.69B5.3680330. [DOI] [PubMed] [Google Scholar]
  8. Flatow E. L., Cordasco F. A., Bigliani L. U. Arthroscopic resection of the outer end of the clavicle from a superior approach: a critical, quantitative, radiographic assessment of bone removal. Arthroscopy. 1992;8(1):55–64. doi: 10.1016/0749-8063(92)90136-y. [DOI] [PubMed] [Google Scholar]
  9. Flatow E. L. The biomechanics of the acromioclavicular, sternoclavicular, and scapulothoracic joints. Instr Course Lect. 1993;42:237–245. [PubMed] [Google Scholar]
  10. Fukuda K., Craig E. V., An K. N., Cofield R. H., Chao E. Y. Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am. 1986 Mar;68(3):434–440. [PubMed] [Google Scholar]
  11. Heinz W. M., Misamore G. W. Mid-shaft fracture of the clavicle with grade III acromioclavicular separation. J Shoulder Elbow Surg. 1995 Mar-Apr;4(2):141–142. doi: 10.1016/s1058-2746(05)80069-2. [DOI] [PubMed] [Google Scholar]
  12. Henry M. H., Liu S. H., Loffredo A. J. Arthroscopic management of the acromioclavicular joint disorder. A review. Clin Orthop Relat Res. 1995 Jul;(316):276–283. [PubMed] [Google Scholar]
  13. Kretschmer G. Luxatio acromioclavicularis mit Bruch der Clavicula im mittleren Drittel. Monatsschr Unfallheilkd Versicher Versorg Verkehrsmed. 1970 Jul;73(7):331–337. [PubMed] [Google Scholar]
  14. Lancourt J. E. Acromioclavicular dislocation with adjacent clavicular fracture in a horseback rider. A case report. Am J Sports Med. 1990 May-Jun;18(3):321–322. doi: 10.1177/036354659001800317. [DOI] [PubMed] [Google Scholar]
  15. Lemos M. J. The evaluation and treatment of the injured acromioclavicular joint in athletes. Am J Sports Med. 1998 Jan-Feb;26(1):137–144. doi: 10.1177/03635465980260010801. [DOI] [PubMed] [Google Scholar]
  16. MOSELEY H. F. Athletic injuries to the shoulder region. Am J Surg. 1959 Sep;98:401–422. doi: 10.1016/0002-9610(59)90534-3. [DOI] [PubMed] [Google Scholar]
  17. McCluskey G. M., 3rd, Todd J. Acromioclavicular joint injuries. J South Orthop Assoc. 1995 Fall;4(3):206–213. [PubMed] [Google Scholar]
  18. McPhee I. B. Inferior dislocation of the outer end of the clavicle. J Trauma. 1980 Aug;20(8):709–710. doi: 10.1097/00005373-198008000-00015. [DOI] [PubMed] [Google Scholar]
  19. Mulier T., Stuyck J., Fabry G. Conservative treatment of acromioclavicular dislocation. Evaluation of functional and radiological results after six years follow-up. Acta Orthop Belg. 1993;59(3):255–262. [PubMed] [Google Scholar]
  20. Nguyen V., Williams G., Rockwood C. Radiography of acromioclavicular dislocation and associated injuries. Crit Rev Diagn Imaging. 1991;32(3):191–228. [PubMed] [Google Scholar]
  21. Richards R. R. Acromioclavicular joint injuries. Instr Course Lect. 1993;42:259–269. [PubMed] [Google Scholar]
  22. Tiurina T. V. Vozrastnye osobennosti akromial'no-kliuchichnogo sustava cheloveka. Arkh Anat Gistol Embriol. 1985 Nov;89(11):75–81. [PubMed] [Google Scholar]
  23. Turnbull J. R. Acromioclavicular joint disorders. Med Sci Sports Exerc. 1998 Apr;30(4 Suppl):S26–S32. doi: 10.1097/00005768-199804001-00005. [DOI] [PubMed] [Google Scholar]
  24. Vanarthos W. J., Ekman E. F., Bohrer S. P. Radiographic diagnosis of acromioclavicular joint separation without weight bearing: importance of internal rotation of the arm. AJR Am J Roentgenol. 1994 Jan;162(1):120–122. doi: 10.2214/ajr.162.1.8273649. [DOI] [PubMed] [Google Scholar]
  25. Wang K. C., Hsu K. Y., Shih C. H. Coracoid process fracture combined with acromioclavicular dislocation and coracoclavicular ligament rupture. A case report and review of the literature. Clin Orthop Relat Res. 1994 Mar;(300):120–122. [PubMed] [Google Scholar]
  26. Webb J., Bannister G. Acromioclavicular disruption in first class rugby players. Br J Sports Med. 1992 Dec;26(4):247–248. doi: 10.1136/bjsm.26.4.247. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Wurtz L. D., Lyons F. A., Rockwood C. A., Jr Fracture of the middle third of the clavicle and dislocation of the acromioclavicular joint. A report of four cases. J Bone Joint Surg Am. 1992 Jan;74(1):133–137. [PubMed] [Google Scholar]
  28. Zanca P. Shoulder pain: involvement of the acromioclavicular joint. (Analysis of 1,000 cases). Am J Roentgenol Radium Ther Nucl Med. 1971 Jul;112(3):493–506. doi: 10.2214/ajr.112.3.493. [DOI] [PubMed] [Google Scholar]

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