Quote Originally Posted by darkest9999 View Post
Hi, Thanks for your reply
At the fracture clinic, I was seen by a top consultant and when writing his review notes I saw he had written "approx 2.5cm gap at AC joint". After researching on the internet I think the AC joint refers to the Acromioclavicular joint which is where the Clavicle and Acromion joint together. So I reckon there is a large gap there which should either be smaller or non existing. Does anyone know any more informaton on this?
We need to know if the clavicle is intact itself or if it has a fracture. The AC jt is on thing but an un-united fracture is another. Physio can assist a little with the AC jt. especially in education and in bracing if that is required for sport. However the best solution to return to overhead activities is a stabilisation of that gap.

The majority of AC jt ruptures are left as gaps. This is perhaps due to poor surgical options in the past. These days one should consider what surgical options are available although this is likely to be minimal in the UK healthcare environment

There's a few article here:

Acromioclavicular Joint Separations

Acromioclavicular Joint Dislocations

ACJ Stabilisation

A complete AC joint dislocation that is still painful after about 6 months is usually an indication for stabilization of the joint. However, some acute dislocations that are very displaced are stabilized soon after the injury.
The most widely performed procedure, with the best results has been the Weaver-Dunn procedure and modifications of this.

The procedure involves 3 main steps:

1. Removal of about 1cm of the end of the collarbone, as this is deformed and diseased.
2. Transfer of the coraco-acromial ligament to hold the collarbone down to the shoulder blade.
3. Reinforcement of the transfer with a suture or screw.

The aims are to stabilise and reduce the dislocation.

This is usually performed by open surgery, but can be performed through keyhole surgery (Arthroscopy) nowadays in a few centres.
We perform the arthroscopic technique in certain indications (acute injuries and mobile, reducable dislocations) and the modified Weaver-Dunn using the LARS ligament.