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Acromioclavicular joint injury grading

Dr Yuranga Weerakkody and Dr Frank Gaillard et al.

Acromioclavicular joint injuries are classified most commonly using the 6 grade system described by Rockwood (1998) ³ (which is a modification to the earlier 3 grade classification system described by Allman (1967) ² and Tossy (1963) and takes into account not only the acromioclavicular joint itself, but also the coracoclavicular ligament, the deltoid and trapezius muscles and the direction of dislocation of the clavicle with respect to the acromion. Essentially grades IV, V and VI are variants of grade III ⁶.

type I
- AC ligament : mild sprain
- CC ligament : intact
- joint capsule : intact
- deltoid mucle : intact
- trapezius muscle : intact
- clavicle not elevated with respect to the acromion
type II
- AC ligament : ruptured
- CC ligament : sprain
- joint capsule : ruptured
- deltoid mucle : minimally detached
- trapezius muscle : minimally detached
- clavicle elevated but not above the superior border of the acromion
type III
- AC ligament : ruptured
- CC ligament : ruptured
- joint capsule : ruptured
- deltoid mucle : detached
- trapezius muscle : detached
- clavicle elevated above the superior border of the acromion but coracoclavicular distance is less than twice normal
type IV
- AC ligament : ruptured
- CC ligament : ruptured
- joint capsule : ruptured
- deltoid mucsle : detached
- trapezius muscle : detached
- clavicle displaced posteriorly into trapezius
type V
- AC ligament : ruptured
- CC ligament : ruptured
- joint capsule : ruptured
- deltoid muscle : detached
- trapezius muscle : detached
- clavicle is markedly elevated and coracoclavicular distance is more than double normal (e.g. >25mm)
type VI
- rare
- AC ligament : ruptured
- CC ligament : ruptured
- joint capsule : ruptured
- deltoid muscle : detached
- trapezius muscle : detached
- clavicle inferiorly displaced behind coracobrachialis and biceps tendons.

References

Synonyms & Alternative Spellings

Synonyms or Alternative Spelling	Include in Listings?
Acromioclavicular joint injury classification	✗
Rockwood grading system of acromioclavicular joint injuries	✗
Modified Allman and Tossy grading system of acromioclavicular joint injuries	✗