The collarbone (clavicle) attaches to the roof of the shoulder (acromion) in a joint known as the acromioclavicular (AC) joint. This area of the shoulder is easily defined because it is the bump that you can feel on the top of the shoulder. The collarbone is also stabilized in this area by ligaments called the coracoclavicular ligaments. These ligaments attach the collarbone to the front of the shoulder blade (scapula). Direct trauma to this shoulder area from a fall or a direct hit during sports activities can damage the connections and lead to an injury where the collarbone and roof of the shoulder are no longer sitting next to each other. This is often referred to as an AC separation and leads to elevation of the collarbone that can be felt at the top of the shoulder. When an AC separation is not healing with conservative treatment options, a surgical AC separation treatment may be recommended by Dr. Peter Millett, orthopedic shoulder specialist serving the Vail, Aspen and Denver, Colorado communities.
An AC separation occurs when the clavicle and acromion are no longer aligned correctly. In mild AC separations, the injury may be treated by conservative measures such as rest, sling use and a short physical therapy rehabilitation program. If there is continued pain and limited function of the AC joint because the AC separation is not healing, or an uncomfortable amount of pain associated with overhead activities (such as throwing, lifting and reaching) is present, a minimally invasive AC separation treatment known as arthroscopic shoulder surgery for AC repair can be performed by Dr. Millett.
An AC separation treatment is an exciting new technique that allows for the repair of acute or chronic AC separations not healing with conservative measures. The surgery is performed on an out-patient basis, and full range of motion is quickly re-established within days of the procedure. During this out-patient procedure, also called the “Mumford” procedure, the end of the collarbone is removed through several tiny incisions. Once inside the shoulder, the clavicle is repaired and fixed back to its proper position. This technique is very successful for painful joints (weightlifters, arthritis, or minor separation).
Following a surgical AC separation treatment, patients will start shoulder motion under the direction of Dr. Millett and his team. Patients will be asked to wear a sling to protect the shoulder joint for several weeks following surgery. Eventually, after the ligaments heal, patients will be allowed to progressively strengthen the shoulder and discard the sling. Many patients can expect to return to sporting activities usually around 3 to 4 months following surgery.
For more information on AC separations, or to learn more about AC separation treatment, please contact the office of Dr. Peter Millett, orthopedic shoulder surgeon in the Vail, Aspen and Denver, Colorado area.