Injuries in and around the shoulder, including acromioclavicular joint injuries, occur most commonly in active or athletic young adults. However, pediatric acromioclavicular injuries have also increased owing to the rising popularity of dangerous summer and winter sporting activities. Proper knowledge of the different problems and treatment options for shoulder disorders is necessary to help patients return to their preinjury state.
Acromioclavicular joint injuries are often seen after bicycle wrecks, contact sports, and car accidents. The acromioclavicular joint is located at the top of the shoulder where the acromion process and the clavicle meet to form a joint (see the following image). Several ligaments surround this joint, and depending on the severity of the injury, a person may tear one or all of the ligaments. Torn ligaments lead to acromioclavicular joint sprains and separations.
The distal clavicle and acromion process can also be fractured. Injury to the acromioclavicular joint may injure the cartilage within the joint and can later cause arthritis of the acromioclavicular joint.
Treatment of acromioclavicular separations has been a subject of debate. In general, types I and II injuries are treated nonoperatively in the acute setting, and types IV, V, and VI injuries generally require surgical repair. However, reaching a consensus regarding the optimal management of acute type III injuries has been difficult (see Treatment).