Dislocation of the lateral head of the collar bone (AC joint) is a common injury especially in contact sports where falling on the shoulder often occurs. Ligaments holding the collar bone in place may be torn and the lateral head of the bone may rise up. Treatment is usually conservative, especially in situations where the head of the collar bone rises just slightly. In dislocations, where the collar bone remains unstable and its head has pronouncedly risen, pain and discomfort may cause problems. The posterior movement of the collar bone upon movement and rotation of the arm is often the most prevalent symptom.
The traditional open operations are laborious and uncomfortable for the patient. Furthermore, the outcome may still be compromised. Several arthroscopic techniques for the ligament reconstruction have been developed. In our technique, the ligament complex holding the collar bone in its place is arthroscopically recreated using a hamstring tendon graft from the posterior thigh.
The operation is performed under general anesthesia. After the operation, padded dressing and a sling is applied. Typically, the patient is discharged from the hospital the same day.
Postoperative treatment
The patient wears a sling for four weeks and is permitted to do light rotatory movements and passively lift his/her arm depending on the severity of the pain. The patient can write, use a computer, make coffee, eat, etc. However, the patient must be extremely careful not to harm the reconstruction. The sling is removed after four weeks and active rehabilitation may begin 8 weeks after surgery. There is no hurry to rehabilitate the shoulder. Taking care not to damage the reconstruction by using the arm too early is crucial. The patient may engage in heavy labor 3 months and sports 4–6 months after surgery.
