It is a “dislocation” in the clavicle and acromion joint (bone forming part of the shoulder blade). Acromion is described as the “roof” of the shoulder.
It often occurs after falling on shoulder (bicycle, motorcycle).
The shoulder is very painful and deformed; any attempt to move the arm is difficult.
The diagnosis is confirmed by an X-ray of the shoulder in question. There are many stages of development of this type of injury (6 stages).
Treatment is tailored to the dislocation stage.
When ligaments that hold the clavicle in place are only twisted or partially broken, we will be content with a conservative treatment; the arm will be maintained in a sling for 3 to 4 weeks. Painkillers and anti-inflammatory drugs will be sufficient for healing.
When clavicle tip is moved up, this means destruction or rupture of ligamentsthat keep it in place, and then we propose surgery.
Surgery is addressed especially to younger patients, highly active athletes.
Several surgical techniques have been described. Techniques are chosen depending on the age of dislocation. Some techniques can be done using endoscopy. Older sprains require sometimes the use of tendon grafts.
Surgery is performed within a short hospitalization. After surgery, the arm will be maintained in a sling for four weeks and shoulder mobility will be recovered progressively through physical therapy sessions, which will be proposed as early as the second week of the surgery.
In patients where surgery was not performed at the beginning (weeks after trauma), progress leads to an alteration of the distal clavicle. In this context, we are satisfied rather to achieve a resection of the clavicular tip (arthroscopically), which is sufficient to make pain disappear from the shoulder.