Operation
In most cases, grade Tossy II and III injuries are treated surgically to prevent the following damages in particular, such as chronic instability of the joint and also the ligaments. The operation is endoscopic, which is why usually only small skin incisions are necessary to insert the instruments. The patient is given a general anaesthetic.
Various techniques are available.In many patients, the ligaments are sutured back together again and are also additionally stabilized by an endogenous tendon (augmentation) from the leg (gracilis tendon). The joint capsule is also reconstructed. The duration of the procedure is often around 60 minutes and the patient can usually leave the hospital on the first or second postoperative day, depending on the patient’s condition.
In order to guarantee good healing of the joint, the entire shoulder is subsequently stiffened with an orthosis. This is worn both during the day and at night so that the sutured ligaments can heal well and become stable. Over the next three months, the movement is then rebuilt and increased through targeted physiotherapy, whereby the shoulder must not yet be subjected to heavy loads. Light jogging is allowed after about six weeks.
- Collarbone
- ACG = shoulder – corner joint
- Acromion (shoulder height)
- Ligamentum coracoacromiale
- Ligamentum coraco- claviculare
Healing of the acromioclavicular joint dislocation
A acromioclavicular joint dislocation is usually a benign injury. In the vast majority of those affected, no discomfort or pain is left behind in everyday life or during sports. How much time an acromioclavicular joint replacement takes to heal depends on the degree of injury.
Without surgery, healing usually takes between 2-12 weeks until the injured ligament structures are restored. The more extensive the damage to the acromioclavicular joint is, the sooner surgery is required to correct the acromioclavicular dislocation. This can significantly increase the healing time.
Wires or plates that are inserted into the joint during surgery for stabilization can be removed after 6-10 weeks. This is followed by physiotherapeutic follow-up treatment to achieve complete healing. In most cases, the shoulder is fully resilient again about 12 weeks after the acromioclavicular joint is disrupted.
The healing process can be supported by conservative treatment methods. Physiotherapeutic therapy strengthens the muscles surrounding the shoulder joint and promotes the ability to bear weight. After consultation with the attending physician or physiotherapist, (shoulder-sparing) sports activities can be resumed as soon as the pain subsides, often after 1-2 weeks.
In the case of moderately severe acromioclavicular dislocations, no sports should be taken for 5-6 weeks to allow the partially injured ligaments to heal. Sports in which the shoulder is strained or in which the hands are raised above the head (e.g. volleyball) can only be performed again after about three months. Strong pulling and pushing forces on the shoulder should be avoided if possible to prevent setbacks in the healing process.
It can happen that after the healed acromioclavicular joint is left behind. These complications, in turn, can be treated with medication, injections into the acromioclavicular joint, physiotherapy or surgery.
- Immobilization of the joint through various bandaging techniques
- Physiotherapy in the form of lymph drainage
- Electrotherapy
- Manual therapy or
- Physiotherapy
- Chronic instability of the shoulder joint
- Shoulder joint arthrosis
- Pain or a
- Reduced usability of the arm