X-ray
How are these injuries graded? What would this injury be graded as?
The 6 grade classification system proposed by Rockwood is the most frequently used. Grade I = mild sprain; Grade II = moderate sprain; Grade III = dislocation; Grade IV = posterior displacement of clavicle; Grade V = marked superior elevation of the clavicle; Grade VI = inferior displacement (subcoracoid). This is a grade V injury.
How are grade III injuries manages?
Most are treated conservatively. The selection of which patients with grade III injuries for surgical intervention is difficult, but patients who are particularly thin, require great range of motion or do heavy lifting may benefit from operative repair.
How are grade IV - VI injuries managed?
These require surgical repair, commonly with a hook-plate.
Dislocation of the left acromioclavicular joint, with the clavicle displaced superiorly and widening of the coracoclavicular space (25 mm), consistent with coracoclavicular ligament injury/rupture. This is a grade V injury. Grossly enlocated glenohumeral joint. No fractures detected.