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UK Orthopaedics
Health Information
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Acromioclavicular (AC) Separation
From McDermott EP: Basketball Injuries of the Foot and Ankle. Clin Sports Med 12:386, 1996.
Description
Acromioclavicular (AC) separation is a sprain (partial or complete tear), injury, or inflammation of the ligaments on the top of the shoulder where the collarbone (clavicle) attaches to the shoulder (acromion). The structures involved are the acromioclavicular (AC) and coracoclavicular (CC) ligaments. These attach the clavicle to the acromion (roof of the shoulder, which is part of the scapula (shoulder blade) or coracoid (part of the scapula).
Common Signs and Symptoms –
Notify a physician if you have any of the following:
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Tenderness and swelling or bump on top of the shoulder (at the AC joint)
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Bruising that appears at the site of injury and sometimes the chest (usually within 48 hours)
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Loss of strength or pain with overhead activities or when reaching across the body
Treatment
Initial treatment consists of ice every two to three hours for 20 minutes during the first 72 hours and anti-inflammatory medication to relieve pain. Do mild stretching to prevent shoulder stiffness, and modification of activities to allow the ligaments to heal. Treatment options include surgical and nonsurgical intervention. Return to sports activity is much earlier with nonoperative treatment and is based on type of sport and position, arm injured (dominant versus nondominant), and severity of sprain. Surgical intervention requires 4 to 6 months’ healing before a return to sports is possible. ·
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Nonsurgical treatment usually is recommended and is successful, with full return to activity and no loss of strength for most sprains of the AC joint. A sling is usually prescribed initially for comfort. ·
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Surgical treatment is usually reserved for those with severe sprains, particularly those who are heavy laborers or throwing athletes or whose condition has not improved after 2 to 6 months of conservative treatment.
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