Grade 3 AC joint separation - surgery?

I had similar situation. injury caused by (my) bike v. car crash about a year ago. after about six months of hoping to recover without surgery, I opted for the surgery. It was tough, total inability to use my right arm/shoulder for about a month. getting dressed, sleeping, etc is a real hassel. I went through physical therapy, etc. After a little over a year out, I am still not at full strength. i'm sure there are many opinions; i can tell you the surgery is no picnic. good luck with your decision.

I have the same injury on my right shoulder. I separated it playing rugby four years ago in the Army. It was suggested to me not to do surgery since there is still a good possibility of a serparation during the recovery time. They explained it to me that they cut off a section of the collar bone and then attach new tendons or ligaments. Once I got out of the Army and went to the VA here in Chicago the doctor who examined me said that there is a doctor in Wisconsin who has a great success rate for operating on grade 3 separations. There is also a specialist here in northern Illinois who has great reviews. (Brother in law and two friends had rotator cuffs fixed) I have not recovered fully and have one heck of a time trying to swim and lift weights like I used to. I can do pretty much anything still but am now debating to do surgery this winter in order to hopefully fully recover what I used to have. My advice is that during the physical therapy time if her collar bone does not seem to settle back into its normal place then to make an appointment with a surgeon to get it checked out. My collar bone still sticks up a good inch in comparison to my left collar bone.

I had a grade 3 AC joint separation when I was 21 years old. I am now 41 years old. At the time I wanted the orthopedic surgeon to fix it because I did not like the aesthetics of the bump on my shoulder (Ah, the worries of my youth). He told me that everyone who gets the AC joint reconstructed will eventually develop arthritis in the joint, sometimes debilitating arthritis. He told me that it was not that uncommon to go back several years later and just cut off the lateral 1/3 of the clavicle to get rid of the joint because of arthritis pain. I chose not to have the repair.

20 years later, my injured shoulder works just as well or better than my "normal" shoulder. No pain. No functional limitations. Just as strong. It still looks a little weird. 20 years ago, no one suggested I take part in PT. I just got active as my injury allowed. It took awhile to get back to normal function. It took almost a year for all of the pain to go away. Interestingly after the first month or so I had almost no pain in the AC joint area. All of my pain was in my neck and back as my body remodelled the muscular attachments and function of the shoulder.

It wasn't easy but given my result I am very pleased that I did not have the surgery.

It is not going to go back in to place without surgery. There is just no anatomical way for this to happen. There are no muscles or attachments that will magically reduce this displacement of the collar bone. Without surgery the bump stays. As I said above, this is not necessarily a bad thing.

I separated my right shoulder July 21st on a trail in Kane County Il. Grade 3 separation. I was told by the orthopedic the same thing, that I should be fine letting it heal on its own. Well, it wasn't until I started reading about it that I realized that this weakens the joint and that it will scar over in this position. Meaning the bump on my shoulder is permanent. Even though you may feel better in a week, the joint is unstable and you will loose about 5 to 15 percent strength in the shoulder when doing overhead work or have any pulling torque on your arm. Plus your shoulder will sag because your clavicle is the hanger, so to speak, from which your shoulder hangs and is supported. I thought that the injury caused the clavicle to move up. It doesn't. The shoulder moves down due to lack of support. To me it was unacceptable. I really started to question the doctors opinion about letting it heal. Here are the things you need to consider. If you decide not to do the surgery now, you can do it later. But after 30 days, the scar tissue begins to set. Your joint will be much more difficult to set back into original position. The doc at that point will need to use ligaments from your thigh or a cadaver (a dead person) ligament to reconstruct the ligaments. This will increase the chance for failure. Performing the surgery asap allows the doc more options. In my case, I have opted to do the surgery as soon as possible. Therefore, he will be using a better method called the tightrope method. The surgeon will drill a hole through the clavicle and the Acromion and install a titanium button on top of the clavicle and under the Acromion with a series of high strength wires to pull the joint back together, and then repair my own torn ligaments. This option would not work if you wait more than 30 days because the pressure needed to hold the joint together increases if there is too much scar tissue to fight against. Plus, your own ligaments will be to scarred to be used, hence the need for an alternate source.
I am told I would be trading a scar for a bump. Well, so be it. I'd rather have a car that is internally sound and strong rather than having a great paint job! The functionality and rom is what I want back. so I guess I can look for a cool tattoo to cover the scar. Bid deal. It's only a 4 inch battle scar!
My advice is get the surgery and get it soon. My timeline is 18 days from injury to surgery.
I'll report back when its done and over with. Good luck in your decision!

Edited by mdg2003 2013-08-05 4:55 PM