ORTHOPEDICS/SHOULDER & ELBOW/SHOULDER DISORDERS
A shoulder separation (also called acromioclavicular joint separation or AC separation) is a joint disarticulation:
A shoulder separation is a damage that involves the acromioclavicular joint on the top of the shoulder.
The shoulder joint is shaped at three bones junction: the collarbone (clavicle), the shoulder blade (scapula), and the arm bone (humerus). The scapula and clavicle constitute the joint socket and the humerus has a round head that fits within this socket.
A shoulder separation happens where the clavicle and the scapula come together. The scapula’s end is called the acromion, and the joint between this part of the scapula and the clavicle is called the acromioclavicular joint.
Disarticulation or separation
The terms shoulder separation or shoulder disarticulation are interchangeably used.
At the time these two damages are generally mixed, they are really two very dissimilar disorders.
In a shoulder separation, the clavicle and scapula junction is disturbed. In a shoulder disarticulation, the humerus (arm bone) is displaced from the socket.
Because of such reason, therapies for these two damages types are also different.
A shoulder separation is almost occurring due to a sudden and traumatic incident.
Two frequent descriptions of a shoulder separation are either a direct blow (most seen in football, rugby, or hockey games), or a fall onto an outstretched hand (generally seen after a bicycle or a horse fall).
Shoulder Separation/Signs and Diagnosis
Severe pain is the first sign felt with a shoulder separation.
Usually this pain is followed by inflammation and bruising.
A shoulder separation is frequently often quite apparent and a simple physical exam such an X-ray should be performed to eliminate the risk of bones crack.
Shoulder Separations/Types
Shoulders separations types depends the damage severity and on the displaced bone positioning.
Shoulder separations are classified from type I to type VI:
Type I:
A shoulder separation type I is a damage to the capsule that surrounds the AC joint. (There is no bones disarticulation in this type.)
Type II:
A shoulder separation type is a damage at the AC joint capsule that stabilize the clavicle. (The coracoclavicular ligament is partially torn).
Type III:
A shoulder separation type III is almost the same damage as in type II but more important.
Type IV:
A shoulder separation type IV is a rare damage occurring when the clavicle is pushed behind the AC joint.
Type V:
A shoulder separation type V is an accentuated type III.
In this type, the muscle above the AC joint is wounded by the end of the clavicle.
Type VI:
A shoulder separation type VI is also extremely rare. In this type, the clavicle is pushed down and lodged below the coracoid.
Therapy
The therapy of a shoulder separation depends on both criteria: Damage severity and separation type.
Type I and II of shoulder separations are usually treated without surgery.
Type III of shoulder separations occasionally recommend classical surgery.
Finally, regarding type IV, V, and VI of shoulder separations, the reality is that these damages forms are quite exceptional and the great bulk of separated shoulders are of types I to III.