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Dislocation, Acromioclavicular Joint

Differential Diagnoses

Acute traumatic bursitis
Adhesive capsulitis
Clavicle fracture
Glenohumeral arthritis
Glenohumeral shoulder dislocation
Impingement syndrome
Rotator cuff injuries

Specialists

Occupational Therapist
Orthopedic (Orthopaedic) Surgeon
Physiatrist
Physical Therapist
Sports Medicine Physician

Comorbid Conditions

Bursitis
Diabetes mellitus
Infection of wound or skin
Osteomyelitis
Osteoporosis
Smoking

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Duration is determined by the grade of AC joint separation, whether the injury occurred on the dominant or the non-dominant side, and presence of other injuries. For non-dominant injuries, individuals may return to work earlier if duties can be performed with one hand. Dominant-side injuries may require longer disability, because individuals are not able to use their arm above the waist until healing is complete.

Disability may be longer for occupations that require manual dexterity, lifting, carrying, throwing, or overhead work. Surgical repair/reconstruction may increase the duration of disability.

Duration Trends from Reference Data

DURATION TRENDS

ICD-9-CM: 831.04, 831.14

Cases	Mean	Min	Max	No Lost Time	Over 6 Months
976	47	0	189	0.1%	0.2%

Percentile:	5^th	25^th	Median	75^th	95^th
Days:	7	21	37	63	119

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes

	ICD-9-CM:
	831 -	Dislocation of Glenohumeral Joint (Shoulder)
	831.04 -	Dislocation of Glenohumeral Joint (Shoulder), Closed, Acromioclavicular Joint
	831.14 -	Dislocation of Glenohumeral Joint (Shoulder), Open, Acromioclavicular Joint (Clavicle)

Complications

Skin abrasions are common with this type of injury and should be monitored for signs of infection. Pressure from a sling or harness can lead to skin ulceration and potential for infection. Muscle weakness, chronic pain, and chronic deformity of the shoulder may occur. Acute injury to the brachial plexus or blood vessels may be associated with grades IV through VI injuries. Development of osteoarthritis in the affected joint is a late complication.

Complications of surgery may include infection, hematoma formation, scar formation, recurrence of deformity, loosening or migrating screws or wires, and need for subsequent surgery.

Source: Medical Disability Advisor

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