Navigation Links
Healing a Shoulder Separation
Date:4/1/2009

Disagreement exists on how to treat a mid-level, common injury

ROSEMONT, Ill., April 1 /PRNewswire-USNewswire/ -- While low-level shoulder separations can commonly be treated nonsurgically and high-level injuries often require surgery, a literature review published in the April 2009 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) finds that many surgeons still disagree on the best course of treatment for those injuries that fall in between.

  • Shoulder separations, clinically known as acromioclavicular joint injuries, represent nearly half of all athletic shoulder injuries.
  • These injuries result from a fall onto the tip of the shoulder with the arm tucked in toward the body.

"Shoulder separation" is not a truly accurate term for this type of injury, which is not a separation of the shoulder joint itself, but rather a disruption or dislocation of the acromioclavicular joint (also called the AC joint), where the collarbone (clavicle) meets the highest point of the shoulder blade (acromion).

If the force of the fall is severe enough, the ligaments attaching to the underside of the clavicle may also be torn. The severity or "type" of injury is classified by the amount and direction of joint separation seen on x-rays. If the underside of the clavicle is torn, it is referred to as a major injury. Signs and symptoms of AC joint injuries range from a minor deformity and mild pain, to a very painful, severe deformity. However, even more serious separations can often be treated successfully with proper attention.

"AC joint injuries are not benign and should not be ignored," says Ryan Simovitch, M.D., orthopaedic surgeon specializing in the shoulder, Palm Beach Orthopaedic Institute, Palm Beach Gardens, Florida. "Nonsurgical treatment does not mean you can neglect the injury. Many patients who follow appropriate treatment and a rehabilitation program can have clinical success without surgery. At the same time, surgery has an important role in high grade injuries."

Nonsurgical options -- which help treat the injury and manage pain for minor sprains (clinically called type I and II AC joint injuries) of the shoulder ligaments include:

  • slings
  • cold packs
  • over-the-counter pain and anti-inflammatory medications

Sometimes, other types of supports may be used to help lessen AC joint motion and reduce pain. Surgery is almost always recommended for major or high level injuries (also called type IV, V, and VI injuries), as well as less serious injuries that do not respond to nonsurgical treatment. Both surgical and nonsurgical types of treatment must include rehabilitation to restore and rebuild the patient's motion, strength, and flexibility.

The treatment of the mid level injuries (type III) remains controversial, with nonsurgical treatment favored in most instances and surgical reconstruction of the acromioclavicular joint reserved for cases in which the joint demonstrates persistent instability.

"Nearly 50 years after the initial papers describing type III acromioclavicular joint injuries, there is still a lack of consensus on the best treatment for them," Simovitch says. "So far, most studies

do not show a significant difference in outcomes between nonsurgically and surgically treated patients with this type of injury. Also, while most orthopaedic surgeons agree that type IV and higher injuries should be treated surgically, we haven't reached a consensus on which surgical technique is best. Over the years, however, arthroscopic and open treatment options for AC joint reconstruction have made significant advances."

Although the issue has not been fully researched, the study authors suggest that certain patients with Type III injuries, such as heavy laborers and athletes who perform frequent overhead motions, might benefit more from surgical reconstruction.

JAAOS

AAOS

Shoulder separation

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.


'/>"/>
SOURCE American Academy of Orthopaedic Surgeons
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. ACell, Inc. Founder Mentioned on the Oprah Winfrey Show as Inventor of Powder for Healing Severed Fingers
2. Family skeletons detrimental to healing
3. Wound Be Gone: Quickly Gaining Strong Support from Clinician Experts in the Field of Wound Healing
4. Animals Respond to Acupunctures Healing Touch
5. New clues to healing arthritis caused by traumatic injury
6. SCAN: Delivering Bone Disorder Diagnosis, Fracture Healing
7. SCAN: Delivering bone disorder diagnosis, fracture healing
8. Deciphering the bodys healing secrets
9. World-renowned Instructor of the Healing Practice of Qigong to Teach in Los Angeles Mar. 7 & 8
10. The Healing Power of Ancient Minerals Magnesium Oil Now Available Down Under
11. Researchers detail how aging undermines bone healing
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/27/2017)... ... March 27, 2017 , ... Osteitis pubis may be ... groin injury, it occurs when the muscles around the pelvis become inflamed. Over ... the lower torso, as well as accompanying tenderness and weakness. Without proper intervention, ...
(Date:3/27/2017)... ... March 27, 2017 , ... The Association of Healthcare and ... hold their first Northeast Regional AHVAP Meeting. For 2017, Dr. Hayes will provide ... and value analysis professionals have a ‘seat at the table’ with clinical committees ...
(Date:3/27/2017)... ... March 27, 2017 , ... Mt. Angel ... of a months-long rebranding effort. This includes the introduction of new packaging and ... and market research, we learned that a simple, proactive approach to wellness is ...
(Date:3/27/2017)... ... March 27, 2017 , ... Harris Communications, Inc., a leading provider ... its latest products to the Deaf Seniors of America Conference, April 4-7 at the ... meet with knowledgeable ASL friendly staff from Harris Communications and to try out the ...
(Date:3/24/2017)... ... 2017 , ... Vighter established its NAEMT Authorized Training Center ... Trauma Life Support (PHTLS) course scholarships to four medics assigned to the Minnesota ... cooperation with the American College of Surgeons to promote critical thinking in addressing ...
Breaking Medicine News(10 mins):
(Date:3/27/2017)... SAN FRANCISCO , March 27, 2017  Twist ... high-quality DNA synthesis, today announced that it raised an ... a total of $166 million. "It ... as we expand our reach and continue to deliver ... in multiple market segments," commented Emily M. Leproust, Ph.D., ...
(Date:3/27/2017)... DIEGO , March 27, 2017 Arena ... company focused on developing novel, small molecule drugs across multiple ... President and Chief Executive Officer, will present a corporate update ... 4 at 3:40pm ET.  The conference will take place April ... New York , NY.  ...
(Date:3/24/2017)... 24, 2017 New England Pediatric Device Consortium ... award including funding and in-kind service towards the commercialization ... "Making blood draws less traumatic for children ... hospital experience better.  We,re looking forward to working with ... improve care for the kids we treat," said ...
Breaking Medicine Technology: