AC joint dislocation

Luxation or dislocation can occur after a person falls on their shoulder or extended arm (often in sports accidents, for example, with cycling, football and skiing). When the ligaments that stabilise the clavicle (collarbone) are torn, causing the clavicle to be upwardly displaced by the attaching muscles, a ‘stair position’ is formed and the end of the clavicle assumes a subcutaneous position.

Downward pressure on the end of the clavicle creates a ‘piano key phenomenon’, which is the up and down movement of the end of the clavicle.

Diagnosing the degree of dislocation takes place, on the one hand, through clinical examination and, on the other, through additional ultrasound and radiographic examinations, with or without stress tests. This involves wearing a weight at the end of the arm so that, on the radiography, a shift can be observed, between the clavicle and acromion (acromioclavicular or ‘AC’).

Treatment may or may not be surgical depending on the injury severity.

• Non-surgical intervention

A number of cases can be treated non-surgically with lasting success. The arm is stabilised in a sling for a few weeks until the pain is under control. Lifting and risky sports should be avoided for approximately six weeks. Inflammation inhibitors and antalgic physiotherapy can help promote healing.

• Surgical intervention

In case of severe displacement of the clavicle tip or people who perform physically demanding work, surgical repair is recommended due to the high risk of permanent discomfort here, such as neck pain due to the protruding clavicle irritating the trapezius muscle (muscle on top of the back). Surgical intervention is also elected for (elite) athletes (cyclists, motocross riders ... ) to ensure rapid sports recovery.

Latest publication date: 10/01/2024