acromioclavicular joint dislocation
Introduction
Introduction to acromioclavicular joint dislocation Dislocation of the acromioclavicular joint is not uncommon. There may be local pain, swelling and tenderness. The abduction or lifting of the injured limb is difficult. The flexion and extension exercises are also limited. The local pain is intensified. The acromioclavicular joint can be touched during the examination. A depression that can touch the acromioclavicular joints loose. Braking after manual reduction is more difficult, so the operation rate is higher, and this dislocation has a history of trauma. basic knowledge The proportion of illness: 0.012% Susceptible people: no specific population Mode of infection: non-infectious Complications: joint dislocation, shoulder dislocation
Cause
Cause of acromioclavicular joint dislocation
Direct violence (60%):
The acromioclavicular joint dislocation has a history of trauma. The stability of the acromioclavicular joint mainly depends on the maintenance of the joint capsule, the acromioclavicular ligament and the sacral ligament. The dislocation is caused by direct violence. Dislocation of the acromioclavicular joint can be dislocated due to direct violence from the upper part to the shoulder of the shoulder. The direct impact of the violence on the top of the shoulder or the shoulder when falling can cause dislocation of the acromioclavicular joint.
Indirect violence (30%):
Indirect violence excessively pulls the shoulder joint down and causes dislocation, or the upper limb sticks to the chest wall and falls, and the shoulder or front or back hits the ground. Its force acts on the shoulder end, causing the shoulder blade to move forward and downward (or backward), causing dislocation. In the case of light injury, only the joint head is torn and there is no deformity shift. In severe cases, the acromioclavicular ligament, sacral ligament and other fractures, the outer end of the clavicle is displaced downward and inward due to the action of the trapezius muscle, so the acromioclavicular joint deformed.
For example, only the joint capsule and the acromioclavicular ligament are ruptured, while the sacral ligament is not broken, and the outer end of the clavicle is displaced upward, which is a subluxation, such as the joint capsule and the acromioclavicular ligament rupture, accompanied by the rupture of the sacral ligament, the outer end of the clavicle. Completely separated from the shoulder, completely dislocated.
Prevention
Acromioclavicular joint dislocation prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Acromioclavicular joint dislocation complications Complications, joint dislocation, shoulder dislocation
This disease is generally uncomplicated.
Symptom
Acromioclavicular joint dislocation symptoms common symptoms calcified ligament rupture after shoulder dislocation
This dislocation has a history of trauma, because the acromioclavicular joint is located under the skin, it is easy to be seen that the local high, bilaterally more obvious, may have local pain, swelling and tenderness; acromioclavicular joint is the fulcrum of upper limb movement, in the shoulder strap function And kinetics occupy an important position, is one of the indispensable joints of the upper extremity abduction, while participating in the flexion and extension of the shoulder joint, the limb abduction or lifting is difficult, flexion and extension It is also limited, local pain is intensified, and a depression can be felt at the acromioclavicular joint during examination, and the acromioclavicular joint can be loosened.
According to the degree of injury and ligament rupture, Zlotsky et al. divided it into three or three types. Type I: a little ligament at the acromioclavicular joint, tearing of the joint capsule fiber, stable joints, mild pain, and normal X-ray photographs. However, there may be periosteal calcification shadows at the lateral end of the clavicle. Type II: acromioclavicular joint capsule, shoulder ligament tear, sacral ligament no damage, the outer end of the clavicle is lifted, showing a semi-dislocation state, and the pressure is floating. There are movements before and after, X-ray film shows that the outer end of the clavicle is higher than the shoulder peak, type III: acromioclavicular ligament, the ligament ligament tears at the same time, causing obvious dislocation of the acromioclavicular joint.
Type
1. The first type has mild swelling and tenderness at the acromioclavicular joint. Clinical examination and X-ray film can not find "semi-dislocation" or "true dislocation" on the lateral side of the clavicle.
2. The second type has the same signs at the acromioclavicular joint. Compared with the contralateral side, the lateral end of the clavicle is relatively high, and the elastic compression is applied. The X-ray can be seen on the lateral side of the collarbone. In comparison, at least 1/2 of them have been dislocated, but not completely dislocated.
2. The lateral end of the third type of clavicle has been picked above the shoulder peak. The local swelling is also heavier than the above two types, and the shoulder joint activity is also affected. Any movement of the shoulder joint will aggravate the pain at the acromioclavicular joint.
Examine
Examination of acromioclavicular joint dislocation
No relevant laboratory tests.
X-ray examination can clearly show that the outer end of the clavicle is displaced upwards, the acromioclavicular joint is subluxated, its upward displacement is light, and the swelling is not obvious. The diagnosis is difficult. Sometimes it is necessary to simultaneously pull the upper limbs and take the shoulder joints on both sides. X-ray film, or the patient standing two hand-held heavy objects to take the two-shoulder lock joint orthotopic X-ray film, contrast examination, to confirm the diagnosis.
Diagnosis
Diagnosis and diagnosis of acromioclavicular joint dislocation
1. Dislocation of the shoulder joint: the injury mechanism is similar to the disease, and it is also characterized by swelling and pain in the shoulder and limited activity. However, there are square shoulder deformities, but the ribs and the shoulder joints are elastically fixed, and the two often exist together.
2. Surgical neck fracture of the humerus: Symptoms and signs are similar, but the disease is swollen and the fatigue is obvious. The upper end of the rib is ring-shaped tenderness. There may be abnormal activity. The line of the Ext line is located at the outer neck of the skin, or both. .
3. Shoulder peak fracture: all shoulder swelling and pain, but the tender point is located in the shoulder bee, there may be a certain degree of mobility during passive abduction; X-ray film can be seen shoulder fracture.
4. Clavicle fracture: There is bone squeak and bone rubbing at the clavicle, and the X-ray can be clearly diagnosed.
