608:
treatment to help ease the pain and muscle spasm. After about four weeks range of motion exercises can be started. Passive exercises are done which the shoulder joint is moved but the muscles stay relaxed. After about six to eight weeks active therapy is started. Such exercises can include isometric strengthening which works the muscles without straining the healing of the joint. After about three months, more active strengthening will be incorporated which focus on improving the strength and control of the rotator cuff muscles and the muscles around the shoulder blade. The exercises that the therapist gives the patient to be done at home should be done to be able to get a better recovery in the long run.
604:, which involves cutting off the end of the clavicle portion, partially sacrificing the coracoacromial ligament and suturing the displaced acromial end to the lateral aspect of the clavicle for stabilization, then often some form of additional support is introduced to replace the coracoclavicular ligament(s). Variations of this support includes grafting of tendons from the leg or the use of synthetic sutures or suture anchors. Other surgeries have used a Rockwood screw that is inserted initially and then removed after 12 weeks. Physical therapy is always recommended after surgery, and most patients get flexibility back, although possibly somewhat limited.
456:
516:
504:
492:
480:
468:
306:. The separation is classified into 6 types, with 1 through 3 increasing in severity, and 4 through 6 being the most severe. The most common mechanism of injury is a fall on the tip of the shoulder or also a fall on an outstretched hand. In falls where the force is transmitted indirectly, often only the acromioclavicular ligament is affected, and the coracoclavicular ligaments remain unharmed. In ice hockey, the separation is sometimes due to a lateral force, as when one gets forcefully checked into the side of the rink.
632:
37:
644:
315:
620:
656:
238:
593:
do receive it, and avoid the added risks that surgery may present. Those with type III injuries who opt out of surgery often have faster recovery times, avoid hospitalization, and are able to return to work or sports sooner. Some studies suggest early surgical treatment of type III separation may benefit laborers and athletes who perform overhead motions. The potential benefit of surgical treatment for type III remains unproven.
386:
607:
After one does have surgery, a sling should be worn to support and protect the shoulder for a few days. For the first couple physical therapy visits, the treatment will focus on controlling the pain and swelling. Type of treatment can include, ice and electrical stimulation, massage, or other hand on
596:
There have been many surgeries described for complete acromioclavicular separations, including arthroscopic surgery. There is no consensus on which is best. There has been a focus on attempting to restore horizontal, as well as vertical, instability. A review found that although horizontal stability
559:
Once the pain has eased, range-of-motion exercises can be started followed by a strength training program. The strength training will include strengthening of the rotator cuff, and shoulder blade muscles. With most cases, the pain goes away after three weeks. Although full recovery can take up to six
444:
of the scapula. The distal clavicle is found in 2 orientations, either subacromial or subcoracoid. With the subcoracoid dislocation, the clavicle becomes lodged behind the intact conjoined tendon. The posterior superior AC ligaments, which often remain attached to the acromion, get displaced into the
592:
Type IV, V, and VI shoulder separations are very uncommon but require surgery. There is some debate among orthopedic surgeons, however, about the treatment of type III shoulder separation. Many with type III shoulder separation who do not undergo surgical treatment recover just as well as those who
563:
Those who do have a separated shoulder will most often return to having full function, although some may have continued pain in the area of the AC joint. With the continued pain there are some things that maybe causing it. It may be due to an abnormal contact between the bone ends when the joint is
675:
Acromioclavicular joint dislocation is a common injury to the shoulder and is occurs most often in athletes. This injury has a higher prevalence in men compared to women and approximately 5 men for every 1 women experience this type of injury. Amongst women, the most common sport that lead to this
376:
A Type II AC separation involves complete tearing of the acromioclavicular ligament, as well as a partial tear (but not a full tear) of the coracoclavicular ligaments. This often causes a noticeable bump on the shoulder and partial or incomplete dislocation. This bump is permanent. The clavicle is
322:
The acromion of the scapula is connected to the clavicle by the superior acromioclavicular ligament. The coracoclavicular ligaments connect the clavicle to the coracoid process. The two ligaments that form the coracoclavicular ligaments are the trapezoid and conoid ligaments. These three ligaments
348:
Diagnosis is based on physical examination and an x-ray. A physical examination can identify point tenderness, pain at the AC joint with cross-arm adduction, and pain relief with an injection of a local anesthetic. The cross-arm adduction will produce pain specifically at the AC joint and will be
555:
Literature regarding long-term follow-up after surgical repair of type III injuries is scarce, and those treated nonoperatively generally do quite well. Many studies have come to the conclusion that non-surgical treatment is as good as or better than surgical treatment, or that anything attained
666:
Some physical therapy exercises that can be performed to help rehab the shoulder are: While standing and using a theraband you can perform Y, T, and I’s, Internal shoulder rotation, External shoulder rotation, Shoulder extensions, and
Scapula squeezes While lying on your side you can perform
422:
stripped off of the acromion as well as the clavicle. This is type III but with exaggeration of the vertical displacement of the clavicle from the scapula. Distinguishing between Type III and Type V separations based on radiographs is difficult and often unreliable between surgeons. Type V is
397:. A significant bump, resulting in some shoulder deformity, is formed by the lateral end of the clavicle. This bump, caused by the clavicle's dislocation, is permanent. The clavicle can be moved in and out of place on the shoulder. A radiographic examination will show the results as abnormal.
377:
unstable to direct stress examination. On radiographs, the lateral end of the clavicle may be slightly elevated by pressing on the sternal aspect of the clavicle forcing the acromial end down, and by releasing, it may pop back up eliciting a piano key sign due to the tearing of the AC.
405:
This is a type III injury with avulsion of the coracoclavicular ligament from the clavicle, with the distal clavicle displaced posteriorly into or through the trapezius and may tent the posterior skin. A displaced clavicle is easily seen on a radiograph. It is important to evaluate the
667:
internal rotation and external rotation with a light weight. The light weight can be any type of object such as a 1-5 lb dumbbell weight, or a soup can. Also you can foam roll the pectorals. With the foam roller you can also lie on your back on top of it and do snow angels.
200:
It is most commonly due to a fall onto the front and upper part of the shoulder when the arm is by the side. They are classified as type I, II, III, IV, V, or VI with the higher the number the more severe the injury. Diagnosis is typically based on physical examination and
241:
Acromion-clavicle disjunction (left shoulder) — note that the shoulder is lower and the "piano key"; the scar on the photograph and the screws on the radiography are ostheosynthesis material from a former trauma repair, without any connection with the present
435:
This is type III with inferior dislocation of the distal end of the clavicle below the coracoid. This injury is associated with severe trauma and frequently accompanied by multiple other injuries. The mechanism is thought to be severe hyperabduction and
556:
because of surgery is quite limited. It appears that after a while, the body "remodels" the joint, either expanding the distal clavicle or causing it to atrophy. There may also be the potential that surgical repair may be less painful in the long run.
367:
A Type I AC separation involves direct trauma to the shoulder causing the injury to ligaments that form the joint, but no severe tearing or fracture. It is commonly referred to as a sprain. For a type 1 AC separation, the joint does not lose stability.
1602:
1587:
551:
Most non-surgical treatment options include first immobilizing the arm with a sling for approximately 2 weeks followed by gradually improving shoulder movement using physical therapy to build up the muscles and help stabilize the joint.
1208:
Kraeutler MJ, Williams GR Jr, Cohen SB, Ciccotti MG, Tucker BS, Dines JS, Altchek DW, Dodson CC (October 2012). "Inter- and intraobserver reliability of the radiographic diagnosis and treatment of acromioclavicular joint separations".
688:
1.8 out of 10,000 people are estimated to experience an acromioclavicular joint discolation per year, and this type of injury is the most common in injury experienced by adults who participate in sports that include body contact.
228:
among those who play hockey, football, and rugby. Those affected are typically 20 to 30 years old. Males are more often affected than females. The injury was initially classified in 1967 with the current classification from 1984.
197:. Symptoms include non-radiating pain which may make it difficult to move the shoulder. The presence of swelling or bruising and a deformity in the shoulder is also common depending on how severe the dislocation is.
349:
done by elevating the arm to a 90° angle, flexing the elbow to a 90° angle, and adducting the arm across the chest. The pain in the shoulder is hard to pinpoint due to the shared innervation of the AC joint and the
531:
Treatment of a separated shoulder depends on the severity of the injury. When beginning treatment, the first steps should be to control inflammation, and to rest and ice the joint. Anti-inflammatories such as
572:
Surgical interventions including repositioning of the shoulder joint and repairing torn ligaments may be necessary for severe injuries in which the shoulder is dislocated. Medical device implants including
212:
Generally types I and II are treated without surgery, while type III may be treated with or without surgery, and types IV, V, and VI are treated with surgery. For type I and II treatment is usually with a
597:
can be more reliably restored with additional acromioclavicular joint reconstruction (in addition to coracoclavicular ligament reconstruction), there is no clear advantage with respect to outcomes.
423:
manifested by a 2- to 3-fold increase in the coracoclavicular distance. The shoulder manifests as a severe droop, secondary to downward displacement of the scapula and humerus due to loss of the
544:
Type I and type II shoulder separation are the most common types and rarely need surgery. However, the risk of arthritis with type II separations is greatly increased. If it becomes severe, the
1673:
1378:"Acromioclavicular joint augmentation at the time of coracoclavicular ligament reconstruction fails to improve functional outcomes despite significantly improved horizontal stability"
577:
screws, a hook plate, fixation pins, and surgical wire may be necessary for repair of the joint. Most of these devices need to be surgically removed after the shoulder has healed.
445:
AC interval, making anatomic reduction difficult. The tissue needs to be surgically cleared and then reattached after reduction. Most patients with type VI injuries have
1503:
1666:
676:
injury type is cycling. Amongst men, accidents or hits in sports such as boxing, football, ice hockey, and martial arts are the most common cause of this injury.
455:
2027:
1659:
449:
that resolves after relocation of the clavicle It is extremely rare and generally only involved with motor vehicle collisions. This requires surgery.
1278:
Press J, Zuckerman JD, Gallagher M, Cuomo F (1997). "Treatment of grade III acromioclavicular separations. Operative versus nonoperative management".
393:
In a Type III AC separation both acromioclavicular and coracoclavicular ligaments are torn without significant disruption of the deltoid or trapezial
1485:
217:
and pain medications for a week or two. In type III injuries surgery is generally only done if symptoms remain following treatment without surgery.
515:
503:
564:
in motion, the development of arthritis, or an injury to a piece of the cushioning cartilage that is found between the bone ends of this joint.
1337:
353:. An injury to the AC joint will result in pain over the AC joint, in the anterolateral neck and in the region in the anterolateral deltoid.
631:
491:
479:
467:
643:
923:
619:
1861:
1123:
917:
655:
988:
Tamaoki, Marcel Js; Lenza, Mário; Matsunaga, Fabio T.; Belloti, João Carlos; Matsumoto, Marcelo H.; Faloppa, Flávio (2019-10-11).
1908:
1499:
1362:
1534:
1257:
741:
Willimon SC, Gaskill TR, Millett PJ (February 2011). "Acromioclavicular joint injuries: anatomy, diagnosis, and treatment".
1087:
356:
X-ray indicates a separated shoulder when the acromioclavicular joint space is widened (it is normally 5 to 8 mm).
1165:
Mazzocca AD, Arciero RA, Bicos J (February 2007). "Evaluation and treatment of acromioclavicular joint injuries".
536:
may also relieve pain and inflammation. The joint should be iced every four hours for fifteen minutes at a time.
990:"Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults"
574:
701:, an estimated 41% of football players at the collegiate level and 40% of quarterback football players from the
702:
441:
205:. In type I and II injuries there is minimal deformity while in a type III injury the deformity resolves upon
1997:
1992:
1765:
178:
147:
1457:
407:
119:
1306:
601:
1812:
863:
Bishop JY, Kaeding C (December 2006). "Treatment of the acute traumatic acromioclavicular separation".
1871:
410:
and posterior dislocation of the AC joint. This injury is generally acknowledged to require surgery.
314:
1759:
1733:
1606:
578:
124:
1755:
1728:
1651:
1554:
1416:
1234:
1190:
888:
766:
350:
206:
73:
66:
237:
36:
30:
Acromioclavicular joint injury, acromioclavicular separation, AC joint separation, AC separation
2032:
1948:
1902:
1682:
1527:
1477:
1408:
1400:
1329:
1287:
1226:
1182:
1119:
1113:
1068:
1027:
1009:
913:
880:
834:
758:
714:
545:
437:
247:
225:
128:
109:
57:
326:
There are four types of soft tissue disruptions that may cause acromioclavicular separation:
1970:
1876:
1856:
1546:
1469:
1392:
1377:
1321:
1218:
1174:
1058:
1017:
1001:
907:
872:
826:
750:
255:
1834:
1694:
1139:
1898:
1785:
1639:
1615:
1611:
1063:
1046:
1022:
989:
876:
291:
279:
275:
221:
817:
Stucken C, Cohen SB (January 2015). "Management of acromioclavicular joint injuries".
2021:
1866:
698:
287:
271:
1558:
1420:
1238:
1194:
770:
2002:
1807:
1775:
1354:
1325:
1088:"Acromioclavicular Separation in Ice Hockey, Typical injury...different mechanism!"
1005:
892:
299:
283:
220:
A separated shoulder is a common injury among those involved in sports, especially
44:
An Xray showing a separated shoulder. Notice the separation between the end of the
1562:
1376:
Jordan, Robert W.; Malik, Shahbaz; Bentick, Kieran; Saithna, Adnan (2018-09-28).
1253:
1222:
406:
sternoclavicular joint also, because there can be an anterior dislocation of the
1686:
586:
446:
418:
This is a more severe form of a type III injury, with the trapezial and deltoid
202:
99:
62:
1435:
1307:"Long-term results of conservative treatment for acromioclavicular dislocation"
1716:
1596:
1550:
1396:
1091:
830:
424:
385:
45:
1404:
1178:
1013:
754:
209:. In type IV, V, and VI the deformity does not resolve with lifting the arm.
1984:
1940:
1848:
1780:
1747:
1634:
1473:
1458:"Treatment of acromioclavicular joint separation: suture or suture anchors?"
589:-assisted coracoclavicular ligament reconstruction may also be considered.
533:
333:
The lateral clavicle may ride upward after being avulsed from its periosteum
303:
246:
Separated shoulders often occur in people who participate in sports such as
1481:
1412:
1230:
1186:
1072:
1031:
884:
838:
762:
1333:
1291:
1936:
1743:
1707:
263:
190:
186:
1579:
1799:
1535:"Injuries of the acromioclavicular joint and current treatment options"
295:
267:
214:
194:
49:
1927:
1922:
1690:
1591:
582:
419:
394:
259:
251:
182:
1456:
Breslow MJ, Jazrawi LM, Bernstein AD, Kummer FJ, Rokito AS (2002).
1962:
1886:
1826:
1795:
1702:
685:
384:
313:
236:
339:
The conoid-trapezoid ligament origin may avulse from the coracoid
1980:
1890:
1844:
1720:
1655:
1958:
1822:
1528:
Wheeless Online online orthopedic resource (for orthopedists)
1436:"Acromioclavicular Injuries: New Management Options Emerge"
330:
The conoid and trapezoid ligaments may tear at any location
1361:. American Academy of Orthopaedic Surgeons. October 2007.
560:
weeks for type II and up to twelve weeks for type III.
1118:. Springer Science & Business Media. p. 255.
1314:
The
Journal of Bone and Joint Surgery. British Volume
1569:
1979:
1957:
1935:
1921:
1885:
1843:
1821:
1794:
1742:
1715:
1701:
1625:
1573:
1286:(2). New York: Hospital for Joint Diseases: 77–83.
159:
134:
118:
108:
98:
90:
82:
72:
56:
26:
21:
705:level experience acromioclavicular dislocations.
1112:Marincek, Borut; Dondelinger, Robert F. (2007).
1533:Rollo J, Raghunath J, Porter K (October 2005).
427:strut. This injury generally requires surgery.
1385:Knee Surgery, Sports Traumatology, Arthroscopy
548:or distal clavicle excision can be performed.
540:Non-surgical (conservative treatment approach)
1667:
1160:
1158:
1156:
1154:
1152:
1150:
1148:
1115:Emergency Radiology: Imaging and Intervention
461:Classification type 1 is the most common type
8:
1138:An examination using radiography (a type of
909:Current Orthopedic diagnosis & treatment
994:The Cochrane Database of Systematic Reviews
336:The acromioclavicular ligaments may be torn
1932:
1712:
1674:
1660:
1652:
1570:
736:
734:
732:
730:
600:A common surgery is some form of modified
78:Pain, deformity, decreased range of motion
35:
18:
1062:
1021:
906:Heckman J, Agarwal A, Schenck RC (2013).
858:
856:
854:
852:
850:
848:
812:
810:
808:
806:
804:
802:
800:
389:Type 3 AC joint separation on plain X ray
798:
796:
794:
792:
790:
788:
786:
784:
782:
780:
726:
615:
451:
865:Sports Medicine and Arthroscopy Review
1462:Journal of Shoulder and Elbow Surgery
1254:"Acromioclavicular Joint Separations"
983:
981:
979:
977:
975:
973:
971:
969:
967:
965:
963:
961:
959:
957:
955:
953:
912:. Current Medicine Group. p. 4.
7:
1500:"Acromioclavicular Joint Separation"
951:
949:
947:
945:
943:
941:
939:
937:
935:
933:
1167:American Journal of Sports Medicine
819:Orthopedic Clinics of North America
637:Passively moving the shoulder joint
359:It can be classified into 6 types.
323:add support to the shoulder joint.
1252:Prybyla D, Owens BD (2005-03-15).
1047:"Acromioclavicular Joint Injuries"
877:10.1097/01.jsa.0000212330.32969.6e
649:Side-lying external rotation start
14:
2028:Dislocations, sprains and strains
1862:Anterior cruciate ligament injury
625:Strengthening the shoulder joint.
181:. The AC joint is located at the
1488:from the original on 2000-03-01.
1365:from the original on 2012-06-06.
1343:from the original on 2017-10-10.
926:from the original on 2017-10-12.
743:The Physician and Sportsmedicine
661:Side-lying external rotation end
654:
642:
630:
618:
514:
502:
490:
478:
466:
454:
318:Right shoulder with AC ligaments
1506:from the original on 2010-05-27
1260:from the original on 2007-02-27
1326:10.1302/0301-620X.78B3.0780410
1006:10.1002/14651858.CD007429.pub3
175:acromioclavicular joint injury
1:
521:Classification type 6 is rare
509:Classification type 5 is rare
150:and surgery if still symptoms
1223:10.3928/01477447-20120919-16
1051:Journal of Athletic Training
224:. It makes up about half of
177:, is a common injury to the
141:: Sling and pain medication
2049:
1305:Rawes ML, Dias JJ (1996).
440:of the arm, combined with
86:Type I, II, III, IV, V, VI
1551:10.1191/1460408605ta349oa
1397:10.1007/s00167-018-5152-7
1142:) will show up as normal.
831:10.1016/j.ocl.2014.09.003
189:where it attaches to the
43:
34:
1179:10.1177/0363546506298022
755:10.3810/psm.2011.02.1869
703:National Football League
1998:Achilles tendon rupture
1993:Patellar tendon rupture
1474:10.1067/mse.2002.123904
715:Other shoulder problems
207:lifting the arm upwards
179:acromioclavicular joint
148:Conservative management
408:sternoclavicular joint
390:
319:
243:
120:Differential diagnosis
1355:"Shoulder Separation"
1045:Beim GM (July 2000).
602:Weaver-Dunn procedure
497:Classification type 4
485:Classification type 3
473:Classification type 2
388:
317:
240:
94:Trauma such as a fall
1872:Patellar dislocation
1760:Dislocated shoulder
1434:Mirzayan R (2005).
125:Dislocated shoulder
114:Examination, X-rays
1813:Gamekeeper's thumb
1770:Separated shoulder
1729:Dislocation of jaw
1626:External resources
391:
351:glenohumeral joint
320:
244:
171:separated shoulder
67:emergency medicine
22:Separated shoulder
2015:
2014:
2011:
2010:
1949:Rotator cuff tear
1917:
1916:
1903:High ankle sprain
1649:
1648:
1391:(12): 3747–3763.
1256:. eMedicine.com.
583:biological grafts
546:Mumford procedure
438:external rotation
226:shoulder injuries
167:
166:
163:Relatively common
129:clavicle fracture
110:Diagnostic method
16:Medical condition
2040:
1971:Pulled hamstring
1933:
1877:Knee dislocation
1857:Tear of meniscus
1713:
1676:
1669:
1662:
1653:
1571:
1566:
1561:. Archived from
1515:
1514:
1512:
1511:
1496:
1490:
1489:
1453:
1447:
1446:
1444:
1443:
1431:
1425:
1424:
1382:
1373:
1367:
1366:
1351:
1345:
1344:
1342:
1311:
1302:
1296:
1295:
1275:
1269:
1268:
1266:
1265:
1249:
1243:
1242:
1205:
1199:
1198:
1162:
1143:
1136:
1130:
1129:
1109:
1103:
1102:
1100:
1099:
1090:. Archived from
1083:
1077:
1076:
1066:
1042:
1036:
1035:
1025:
1000:(10): CD007429.
985:
928:
927:
903:
897:
896:
860:
843:
842:
814:
775:
774:
738:
658:
646:
634:
622:
612:Physical therapy
575:coracoclavicular
518:
506:
494:
482:
470:
458:
256:horseback riding
173:, also known as
39:
19:
2048:
2047:
2043:
2042:
2041:
2039:
2038:
2037:
2018:
2017:
2016:
2007:
1975:
1953:
1926:
1913:
1881:
1839:
1835:Hip dislocation
1817:
1790:
1738:
1706:
1697:
1680:
1650:
1645:
1644:
1621:
1620:
1582:
1532:
1524:
1519:
1518:
1509:
1507:
1498:
1497:
1493:
1455:
1454:
1450:
1441:
1439:
1438:. eMedicine.com
1433:
1432:
1428:
1380:
1375:
1374:
1370:
1353:
1352:
1348:
1340:
1309:
1304:
1303:
1299:
1277:
1276:
1272:
1263:
1261:
1251:
1250:
1246:
1217:(10): e1483-7.
1207:
1206:
1202:
1164:
1163:
1146:
1140:medical imaging
1137:
1133:
1126:
1111:
1110:
1106:
1097:
1095:
1085:
1084:
1080:
1044:
1043:
1039:
987:
986:
931:
920:
905:
904:
900:
862:
861:
846:
816:
815:
778:
740:
739:
728:
723:
711:
695:
682:
673:
662:
659:
650:
647:
638:
635:
626:
623:
614:
570:
542:
529:
522:
519:
510:
507:
498:
495:
486:
483:
474:
471:
462:
459:
433:
416:
403:
383:
374:
365:
346:
312:
235:
151:
142:
17:
12:
11:
5:
2046:
2044:
2036:
2035:
2030:
2020:
2019:
2013:
2012:
2009:
2008:
2006:
2005:
2000:
1995:
1989:
1987:
1977:
1976:
1974:
1973:
1967:
1965:
1955:
1954:
1952:
1951:
1945:
1943:
1930:
1919:
1918:
1915:
1914:
1912:
1911:
1906:
1899:Sprained ankle
1895:
1893:
1883:
1882:
1880:
1879:
1874:
1869:
1864:
1859:
1853:
1851:
1841:
1840:
1838:
1837:
1831:
1829:
1819:
1818:
1816:
1815:
1810:
1804:
1802:
1792:
1791:
1789:
1788:
1786:Bankart lesion
1783:
1778:
1773:
1763:
1752:
1750:
1740:
1739:
1737:
1736:
1731:
1725:
1723:
1710:
1699:
1698:
1681:
1679:
1678:
1671:
1664:
1656:
1647:
1646:
1643:
1642:
1630:
1629:
1627:
1623:
1622:
1619:
1618:
1599:
1583:
1578:
1577:
1575:
1574:Classification
1568:
1567:
1565:on 2006-10-17.
1545:(4): 217–223.
1530:
1523:
1522:External links
1520:
1517:
1516:
1491:
1448:
1426:
1368:
1346:
1297:
1270:
1244:
1200:
1144:
1131:
1124:
1104:
1078:
1057:(3): 261–267.
1037:
929:
918:
898:
844:
776:
725:
724:
722:
719:
718:
717:
710:
707:
694:
691:
681:
678:
672:
669:
664:
663:
660:
653:
651:
648:
641:
639:
636:
629:
627:
624:
617:
613:
610:
569:
566:
541:
538:
528:
525:
524:
523:
520:
513:
511:
508:
501:
499:
496:
489:
487:
484:
477:
475:
472:
465:
463:
460:
453:
432:
429:
415:
412:
402:
399:
382:
379:
373:
370:
364:
361:
345:
342:
341:
340:
337:
334:
331:
311:
308:
292:crack the whip
234:
231:
222:contact sports
165:
164:
161:
157:
156:
153:Type IV, V, VI
136:
132:
131:
122:
116:
115:
112:
106:
105:
104:Contact sports
102:
96:
95:
92:
88:
87:
84:
80:
79:
76:
70:
69:
60:
54:
53:
41:
40:
32:
31:
28:
24:
23:
15:
13:
10:
9:
6:
4:
3:
2:
2045:
2034:
2031:
2029:
2026:
2025:
2023:
2004:
2001:
1999:
1996:
1994:
1991:
1990:
1988:
1986:
1982:
1978:
1972:
1969:
1968:
1966:
1964:
1960:
1956:
1950:
1947:
1946:
1944:
1942:
1938:
1934:
1931:
1929:
1924:
1920:
1910:
1907:
1904:
1900:
1897:
1896:
1894:
1892:
1888:
1884:
1878:
1875:
1873:
1870:
1868:
1867:Unhappy triad
1865:
1863:
1860:
1858:
1855:
1854:
1852:
1850:
1846:
1842:
1836:
1833:
1832:
1830:
1828:
1824:
1820:
1814:
1811:
1809:
1806:
1805:
1803:
1801:
1797:
1793:
1787:
1784:
1782:
1779:
1777:
1774:
1771:
1767:
1764:
1761:
1757:
1754:
1753:
1751:
1749:
1745:
1741:
1735:
1732:
1730:
1727:
1726:
1724:
1722:
1718:
1714:
1711:
1709:
1704:
1700:
1696:
1692:
1688:
1684:
1677:
1672:
1670:
1665:
1663:
1658:
1657:
1654:
1641:
1637:
1636:
1632:
1631:
1628:
1624:
1617:
1613:
1609:
1608:
1604:
1600:
1598:
1594:
1593:
1589:
1585:
1584:
1581:
1576:
1572:
1564:
1560:
1556:
1552:
1548:
1544:
1540:
1536:
1531:
1529:
1526:
1525:
1521:
1505:
1501:
1495:
1492:
1487:
1483:
1479:
1475:
1471:
1467:
1463:
1459:
1452:
1449:
1437:
1430:
1427:
1422:
1418:
1414:
1410:
1406:
1402:
1398:
1394:
1390:
1386:
1379:
1372:
1369:
1364:
1360:
1356:
1350:
1347:
1339:
1335:
1331:
1327:
1323:
1319:
1315:
1308:
1301:
1298:
1293:
1289:
1285:
1281:
1274:
1271:
1259:
1255:
1248:
1245:
1240:
1236:
1232:
1228:
1224:
1220:
1216:
1212:
1204:
1201:
1196:
1192:
1188:
1184:
1180:
1176:
1173:(2): 316–29.
1172:
1168:
1161:
1159:
1157:
1155:
1153:
1151:
1149:
1145:
1141:
1135:
1132:
1127:
1125:9783540689089
1121:
1117:
1116:
1108:
1105:
1094:on 2006-11-19
1093:
1089:
1082:
1079:
1074:
1070:
1065:
1060:
1056:
1052:
1048:
1041:
1038:
1033:
1029:
1024:
1019:
1015:
1011:
1007:
1003:
999:
995:
991:
984:
982:
980:
978:
976:
974:
972:
970:
968:
966:
964:
962:
960:
958:
956:
954:
952:
950:
948:
946:
944:
942:
940:
938:
936:
934:
930:
925:
921:
919:9781461311072
915:
911:
910:
902:
899:
894:
890:
886:
882:
878:
874:
871:(4): 237–45.
870:
866:
859:
857:
855:
853:
851:
849:
845:
840:
836:
832:
828:
824:
820:
813:
811:
809:
807:
805:
803:
801:
799:
797:
795:
793:
791:
789:
787:
785:
783:
781:
777:
772:
768:
764:
760:
756:
752:
749:(1): 116–22.
748:
744:
737:
735:
733:
731:
727:
720:
716:
713:
712:
708:
706:
704:
700:
699:United States
693:United States
692:
690:
687:
679:
677:
670:
668:
657:
652:
645:
640:
633:
628:
621:
616:
611:
609:
605:
603:
598:
594:
590:
588:
584:
580:
576:
567:
565:
561:
557:
553:
549:
547:
539:
537:
535:
526:
517:
512:
505:
500:
493:
488:
481:
476:
469:
464:
457:
452:
450:
448:
443:
439:
430:
428:
426:
421:
413:
411:
409:
400:
398:
396:
387:
380:
378:
371:
369:
362:
360:
357:
354:
352:
343:
338:
335:
332:
329:
328:
327:
324:
316:
309:
307:
305:
301:
297:
293:
289:
288:skateboarding
285:
281:
277:
273:
272:combat sports
269:
265:
261:
257:
253:
249:
239:
232:
230:
227:
223:
218:
216:
210:
208:
204:
198:
196:
192:
188:
184:
180:
176:
172:
162:
158:
154:
149:
145:
140:
139:Type I and II
137:
133:
130:
126:
123:
121:
117:
113:
111:
107:
103:
101:
97:
93:
89:
85:
81:
77:
75:
71:
68:
64:
61:
59:
55:
51:
47:
42:
38:
33:
29:
25:
20:
2003:Shin splints
1808:Pulled elbow
1776:ALPSA lesion
1769:
1687:subluxations
1683:Dislocations
1640:orthoped/462
1633:
1601:
1586:
1563:the original
1542:
1538:
1508:. Retrieved
1494:
1468:(3): 225–9.
1465:
1461:
1451:
1440:. Retrieved
1429:
1388:
1384:
1371:
1358:
1349:
1320:(B): 410–2.
1317:
1313:
1300:
1283:
1279:
1273:
1262:. Retrieved
1247:
1214:
1210:
1203:
1170:
1166:
1134:
1114:
1107:
1096:. Retrieved
1092:the original
1081:
1054:
1050:
1040:
997:
993:
908:
901:
868:
864:
825:(1): 57–66.
822:
818:
746:
742:
696:
683:
674:
671:Epidemiology
665:
606:
599:
595:
591:
587:arthroscopic
571:
562:
558:
554:
550:
543:
530:
434:
417:
404:
392:
375:
366:
358:
355:
347:
325:
321:
300:roller derby
284:snowboarding
245:
219:
211:
199:
174:
170:
168:
152:
143:
138:
100:Risk factors
1211:Orthopedics
447:paresthesia
185:end of the
63:Orthopedics
27:Other names
2022:Categories
1510:2010-05-05
1442:2006-11-11
1264:2006-11-01
1098:2006-11-01
1086:Bushee S.
721:References
579:Allografts
442:retraction
425:clavicular
46:collarbone
1941:upper arm
1781:SLAP tear
1748:upper arm
1708:ligaments
1635:eMedicine
1502:. ISOST.
1405:0942-2056
1359:OrthoInfo
1014:1469-493X
534:ibuprofen
527:Treatment
344:Diagnosis
310:Mechanism
304:wrestling
160:Frequency
155:: Surgery
135:Treatment
58:Specialty
2033:Shoulder
1937:Shoulder
1909:Turf toe
1744:Shoulder
1734:Whiplash
1559:71546763
1504:Archived
1486:Archived
1482:12070493
1421:52883355
1413:30267185
1363:Archived
1338:Archived
1280:Bulletin
1258:Archived
1239:13873712
1231:23027484
1195:21473317
1187:17251175
1073:16558638
1032:31604007
924:Archived
885:17135974
839:25435035
771:10180712
763:21378494
709:See also
568:Surgical
381:Type III
264:lacrosse
248:football
191:acromion
187:clavicle
144:Type III
74:Symptoms
48:and the
1928:tendons
1923:Muscles
1800:forearm
1695:strains
1691:sprains
1334:8636176
1292:9220095
1064:1323387
1023:6788812
893:7806559
697:In the
431:Type VI
401:Type IV
372:Type II
296:cycling
268:parkour
242:trauma.
195:scapula
193:of the
50:scapula
1703:Joints
1616:831.14
1612:831.04
1557:
1539:Trauma
1480:
1419:
1411:
1403:
1332:
1290:
1237:
1229:
1193:
1185:
1122:
1071:
1061:
1030:
1020:
1012:
916:
891:
883:
837:
769:
761:
585:, and
420:fascia
414:Type V
395:fascia
363:Type I
276:rowing
260:hockey
252:soccer
203:X-rays
91:Causes
1963:thigh
1887:Ankle
1827:thigh
1796:Elbow
1597:S43.1
1555:S2CID
1417:S2CID
1381:(PDF)
1341:(PDF)
1310:(PDF)
1235:S2CID
1191:S2CID
889:S2CID
767:S2CID
686:Italy
680:Italy
280:rugby
233:Cause
215:sling
183:outer
83:Types
1983:and
1981:Knee
1961:and
1939:and
1891:foot
1889:and
1847:and
1845:Knee
1825:and
1798:and
1746:and
1721:neck
1719:and
1717:Head
1693:and
1607:9-CM
1478:PMID
1409:PMID
1401:ISSN
1330:PMID
1288:PMID
1227:PMID
1183:PMID
1120:ISBN
1069:PMID
1028:PMID
1010:ISSN
914:ISBN
881:PMID
835:PMID
759:PMID
302:and
1985:leg
1959:Hip
1925:and
1849:leg
1823:Hip
1705:and
1603:ICD
1588:ICD
1547:doi
1470:doi
1393:doi
1322:doi
1219:doi
1175:doi
1059:PMC
1018:PMC
1002:doi
873:doi
827:doi
751:doi
684:In
298:,
2024::
1766:AC
1756:GH
1689:,
1638::
1614:,
1610::
1595::
1592:10
1553:.
1541:.
1537:.
1484:.
1476:.
1466:11
1464:.
1460:.
1415:.
1407:.
1399:.
1389:27
1387:.
1383:.
1357:.
1336:.
1328:.
1318:78
1316:.
1312:.
1284:56
1282:.
1233:.
1225:.
1215:35
1213:.
1189:.
1181:.
1171:35
1169:.
1147:^
1067:.
1055:35
1053:.
1049:.
1026:.
1016:.
1008:.
998:10
996:.
992:.
932:^
922:.
887:.
879:.
869:14
867:.
847:^
833:.
823:46
821:.
779:^
765:.
757:.
747:39
745:.
729:^
581:,
294:,
290:,
286:,
282:,
278:,
274:,
270:,
266:,
262:,
258:,
254:,
250:,
169:A
146::
127:,
65:,
1905:)
1901:(
1772:)
1768:(
1762:)
1758:(
1685:/
1675:e
1668:t
1661:v
1605:-
1590:-
1580:D
1549::
1543:7
1513:.
1472::
1445:.
1423:.
1395::
1324::
1294:.
1267:.
1241:.
1221::
1197:.
1177::
1128:.
1101:.
1075:.
1034:.
1004::
895:.
875::
841:.
829::
773:.
753::
52:.
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
