Acromioclavicular and Sternoclavicular Joint Injuries

Abstract

Acromioclavicular (AC) and sternoclavicular (SC) joint injuries are caused by trauma to the shoulder. AC joint injuries are common and typically occur during contact sports. Characteristic findings include pain at the AC joint with cross-arm adduction and radiographic joint instability. Low-grade injuries (types I and II) are managed nonoperatively, and high-grade injuries (types IV–VI) are managed operatively. There is controversy regarding the management of type III injuries, but most attempt a trial of nonoperative management before proceeding with surgery. Many operative techniques exist to surgically repair the AC joint. Successful AC joint reconstruction requires anatomic stabilization of the acromioclavicular and coracoclavicular ligaments. SC joint injuries are less common and typically occur during motor vehicle accidents. SC joint injuries have the potential to be life-threatening if the surrounding neurovascular and respiratory structures are compromised. Most SC joint injuries can be successfully managed nonoperatively. Closed joint reduction is necessary for high-grade injuries (type III), and open reduction is required if closed reduction is unsuccessful.