Right AC Joint Dislocation: Symptoms, Recovery, and Medical Insights

Right shoulder acromioclavicular joint dislocation?

Hello, I would like to ask if, at such slow speeds of only 13.5 km/h and 16.2 km/h, a right acromioclavicular (AC) joint dislocation would immediately result in the bone protruding at the moment of the incident? Is it possible to immediately grasp someone's hand to touch the protruding bone? Alternatively, what is the typical symptom progression for a right AC joint dislocation under normal circumstances? How long would it take to return to normal cycling or driving? Additionally, if a physician suspects a long-standing right AC joint dislocation (X-ray: chronic AC dislocation right), what characteristics would be present? If the right AC joint dislocation is an old injury, how long of a medical history or health insurance records would the physician recommend reviewing for appropriateness?

Q, 20~29 year old female. Ask Date: 2022/04/12

Dr. Chen Yongxue reply Orthopedics

Hello, in the acute phase of an acromioclavicular joint dislocation, the symptoms may not be very obvious and can often take weeks after the injury to be diagnosed.
The pain is not as pronounced as with dislocations of other joints.
Therefore, the movements you mentioned can still be performed if there is an acromioclavicular joint dislocation.
Surgical treatment is recommended to minimize future complications.
Thank you.

Reply Date: 2022/04/12

More Info

Understanding right acromioclavicular (AC) joint dislocation involves recognizing the symptoms, recovery process, and underlying medical insights related to this condition. AC joint dislocation typically occurs when there is an injury to the ligaments that connect the acromion (part of the shoulder blade) to the clavicle (collarbone). This injury can happen due to a fall, direct impact, or, as in your case, a low-speed collision.

Symptoms of AC Joint Dislocation
In the event of an AC joint dislocation, symptoms can manifest immediately or develop over time. Common symptoms include:
1. Pain and Tenderness: The most immediate symptom is pain at the top of the shoulder, which may radiate down the arm. Tenderness is often localized over the AC joint.

2. Swelling and Bruising: Swelling around the joint may occur, and bruising can develop as blood vessels are damaged.

3. Deformity: In more severe cases, the end of the clavicle may appear raised or protruding, which is often referred to as a "step deformity."
4. Limited Range of Motion: Patients may experience difficulty moving the shoulder, particularly when lifting the arm or reaching across the body.

5. Instability: In chronic cases, there may be a sensation of instability in the shoulder, particularly when performing overhead activities.

Immediate Reaction and Diagnosis
In your scenario, with the low-speed impact of 13.5 km/hr and 16.2 km/hr, it is possible to sustain an AC joint dislocation, although the severity may vary. If dislocation occurs, the bone may not protrude immediately, and it may not be possible to feel the dislocated joint right away. The body’s response to injury can vary, and while some individuals may notice immediate symptoms, others may experience a gradual onset of pain and swelling.

Recovery Timeline
The recovery period for an AC joint dislocation can vary significantly based on the severity of the injury (classified as Type I to Type VI).
- Type I: Mild sprain with no significant displacement; recovery may take a few days to weeks.

- Type II: Partial dislocation with some displacement; recovery may take several weeks.

- Type III: Complete dislocation with significant displacement; recovery may take several weeks to months, and surgical intervention may be considered.

- Type IV-VI: More severe injuries that often require surgical repair and longer recovery times.

In general, returning to activities such as cycling or driving can take anywhere from a few weeks to several months, depending on the severity of the injury and adherence to rehabilitation protocols.

Chronic AC Joint Dislocation
Chronic AC joint dislocation refers to a long-standing condition where the joint remains dislocated or has not healed properly. Characteristics of chronic dislocation may include:
- Persistent Pain: Ongoing discomfort in the shoulder, especially with overhead activities.

- Decreased Range of Motion: Limited ability to move the shoulder freely.

- Joint Instability: A feeling of looseness or instability in the shoulder joint.

- Changes in Joint Structure: X-rays may show changes in the joint alignment or bone spurs due to chronic stress on the joint.

Medical Records and History
If you suspect that your AC joint dislocation is a chronic issue stemming from a previous injury, it would be prudent to review medical records from the time of the initial injury. Typically, obtaining records from the past 5 to 10 years can provide valuable insights into the history of your shoulder condition, previous treatments, and any imaging studies that may have been performed.

In conclusion, understanding the nuances of AC joint dislocation, including symptoms, recovery, and chronic implications, is essential for effective management and rehabilitation. If you have ongoing concerns or symptoms, consulting with an orthopedic specialist for a thorough evaluation and tailored treatment plan is advisable.

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