ac joint injury
DESCRIPTION
pHYSIOTHERAPYTRANSCRIPT
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ACJoint Injury
ROYDEN DOMINIC DSOUZA
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INDEX• Epidemiology• Etiology• Anatomy• Classification• Clinical Features• Radiology• Treatment• Rehab
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• Contact Sports• Young Males• Motor Vehicle
collisions
EPIDEMIOLOGY
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• Blow to the apex of the shoulder.• Fall on shoulder with arms adducted.
ETIOLOGY
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ANATOMY• Type : Diarthrodial• Stability : •
• Capsule, Deltoid & Trapezius.
Costoclavicular LigamentAcromioclavicular
Horizontal Vertical
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Rockwood Classification
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Type AC lig. CC lig. Muscles Clavicle
Type 1 Sprain Intact Intact Intact
Type 2 Rupture Sprain (D) & (T) Minimal Detachment
Intact
Type 3 Rupture Rupture (D) & (T) Detached Elevated, but <100 % displacement
Type 4 Rupture Rupture (D) & (T) Detached Posteriorly displaced clavicle into trapezius
Type 5 Rupture Rupture (D) & (T) Detached Elevated, but >100%
Type 6 Rupture Rupture Displaced
(D) – Deltoid , (T) – Trapezius , AC – Acromioclavicular , CC – Costoclavicular , lig-Ligament
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• Pain• Tenderness• Swelling• Step Deformity
Clinical Features
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• X- Ray• Bilateral AP• Axillary ( To diagnose Type 4)• Zanca
Radiology
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• Non operative : • Type 1,2 and most of the type 3 patients.
Treatment
ICE RESTSLING
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• Operative : • For type 3,4,5 & 6• Techniques :• ORIF with CC Screw fixation• ORIF with CC Suture fixation• CC Ligament reconstruction
Treatment
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• GOALS• ROM• STRENGTH• PAIN• RETURN TO FUNCTION
Rehab
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References
• http://emedicine.medscape.com/article/92337-overview
• http://www.jospt.org/doi/pdfplus/10.2519/jospt.1997.25.6.390