Ligamentous injury to the acromioclavicular joint +/- the coracoclavicular joint.
>95% are anterior dislocations in adolescents
Usually injured from external rotation and abduction with force applied posteriorly
Exam Features:
Significant pain
High levels of anxiety
No ROM with a sulcus sign
Diagnosis:
X-ray
Point of Care Ultrasound
Management:
Reduction:
Be sure to provide adequate analgesia and muscle relaxation.
Intraarticular Lidocaine is a great alternative to conscious sedation.
See video below for 10 different techniques by Larry Mellick at the Medical College of Georgia
Complications:
Bankart Lesion: a tear of glenoid labrum
Hill-Sachs Fracture: an indentation fracture to the humerus