Luxation acromio-claviculaire

The luxation acromio-claviculaire is a luxation of the Articulation acromio-claviculaire which links the external end of the Clavicule to the Acromion.

It is a frequent and benign lesion concerning the young subject, generally of with a direct traumatism by fall on the stub of the shoulder.

Classification

He was proposed several classifications, simplest includes/understands four stages, by order ascending of gravity:

Stage 1: Simple distorsion acromio-claviculaire , with lesion partial of the ligaments without instability of the clavicle.
Stage 2: Subluxation acromio-claviculaire , with rupture isolated from the ligaments acromio-claviculaires. Discrete mobility of from top to bottom clavicle in " touch piano". No antéro-posterior mobility.
Stage 3: Luxation acromio-claviculaire supplements , by complete rupture of the ligaments acromio-claviculaires and the ligaments coraco-claviculaires, with loss of contact total and permanent of articular surfaces. Visible deformation of the shoulder with important projection of the external end of the clavicle, which one can reduce not simple pressure (" touch piano"). There exists also an abnormal antero-posterior mobility.
Stage 4: Stage 3 with in more one rupture of the cap delto-trapézienne . The external end of the clavicle is palpable directly under the skin.

Treatment

The treatment depends on the stage of luxation. It includes/understands 2 methods:

orthopedic Method: Immobilization hacks elbow with the body of it during 10 days at 3 weeks, followed by a rehabilitation.
Method surgical: Various techniques suggested according to the schools.

Indications

Stages I and II: Orthopedic treatment.
Stage III: Depends on the schools, takes into account the motivation of the patient.
Stage IV: Surgical treatment with repositioning and fixing.

At the chronic stage in front of painful after-effects, the treatment is surgical by résection of the external centimetre of the clavicle.

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