Updated: 4/9/2017

Acromioclavicular Joint

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Questions
3
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Evidence
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https://upload.orthobullets.com/topic/3033/images/cc ligaments v4.jpg

  • Osteology
    • the AC joint is a diarthrodial joint
    • fibrocartilaginous intraarticular disc is located between the osseous segments  
  • Motion
    • majority of motion is from the bones, not through the joint
      • clavicle rotates 40-50° posteriorly with shoulder elevation
      • 8° of rotation through AC joint
      • remainder from scapular rotation and sternoclavicular motion
    • joint itself is limited to gliding motions only
  • Stability
    • acromioclavicular ligament
      • provides horizontal stability
      • has superior, inferior, anterior, and posterior components
        • superior ligament is strongest, followed by posterior  
    • coracoclavicular ligaments (trapezoid and conoid)
      • provides vertical stability
      • trapezoid inserts 3 cm from end of clavicle
        • stabilizer against horizontal and vertical loads
      • conoid inserts 4.5 cm from end of clavicle in the posterior border
        • more important ligament
        • vertical stabilizer of AC joint
      • normal CC distance (superior coracoid to inferior clavicle) is 11-13mm
    • deltotrapezial fascia, capsule, deltoid and trapezius
      •  act as additional stabilizers
 

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Questions (3)
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(SAE07SM.49) A 29-year-old quarterback falls onto his dominant shoulder and sustains the injury shown in Figures 14a and 14b. Management should consist of Review Topic

QID: 8711
FIGURES:
1

an arm sling.

2%

(2/104)

2

nonsteroidal anti-inflammatory drugs and a rapid return to activity.

0%

(0/104)

3

arthroscopic partial claviculectomy.

0%

(0/104)

4

acromioclavicular joint reduction and stabilization.

94%

(98/104)

5

acromionectomy.

1%

(1/104)

ML 1

Select Answer to see Preferred Response

PREFERRED RESPONSE 4

(OBQ04.221) When performing an arthroscopic distal clavicle excision for acromioclavicular joint arthrosis, which of the following structures must be preserved to prevent post-operative anteroposterior instability of the clavicle? Review Topic

QID: 1326
1

Trapezoid ligament

9%

(138/1549)

2

Anterior and inferior acromioclavicular joint capsule

6%

(92/1549)

3

Superior and posterior acromioclavicular joint capsule

76%

(1178/1549)

4

Coracohumeral ligament

3%

(48/1549)

5

Conoid ligament

6%

(87/1549)

ML 3

Select Answer to see Preferred Response

PREFERRED RESPONSE 3
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