EN 
NL Ac instability
A hard blow can cause the AC ligament to be stretched or even broken. We then speak of a AC luxation. Injury to the AC ligament occurs mainly in young avid sportsmen or elderly people after a fall.
- Tossy 1 (ligament stretching)
- Tossy 2 (ligament damage)
- Tossy 3 (damage to also other ligaments around the clavicle).
A Tossy 3 can operative be treated but this depends on several factors. The physiotherapists at Fysiofitaal Tilburg can recognise damage or injury to this joint and are able to provide you with conservative management (physiotherapy) to guide!
To understand the severity of injury to the AC ligament, different grades are used. In a grade 1 Tossy, the AC ligament is only slightly stretched (also called a distortion) and sufficient rest will ensure the necessary recovery. In a grade 2 Tossy, the AC ligament completely torn, causing the clavicle (the clavicle) to stick up slightly. Fortunately, here the clavicula is still attached to two other ligaments. In a grade 3 tossi, both the AC ligament if the coracoclavicular ligaments (trapeziod and coniod ligament) are completely torn and the clavicle protrudes markedly upwards. Here we also speak of a piano key phenomenon.
Complaints and symptoms
Pain when moving the shoulder. Slight swelling may possibly be seen around the joint.
A serious pain at the level of the joint along with swelling. Also, the collarbone is a bit higher and when you press on it, it is mobile.
A continuous pain along with swelling and elevation of the collarbone.
The diagnosis AC-Tossy can be posed using the client's story along with the physical examination. Usually, the piano-tooth phenomenon is involved. The physiotherapists at Fysiofitaal Tilburg are able to provide a AC-Tossy recognise.
Treatments and prognosis
Grade 1 Tossy: Treatment consists mainly of rest using a sling/ sling. By taking it easy along with small exercises, this form of tossi injury will heal on its own.
Grade 2 Tossy: It is important to keep the clavicle at the same height as the scapula as much as possible. This is because scarring will then allow the AC to be repaired. It is advisable here to use a good sling that limits the range of motion in the shoulder.
Grade 3 Tossy: Because the clavicle is significantly elevated, there can be no repair using scarring. The ligaments that are torn will dissolve with time. In young athletic people or those with physically demanding work, an acute surgical procedure is quite often chosen to repair the ligaments. This should then be done within three weeks. In older people or injuries that have been present for some time, a conservative policy (physiotherapy) is chosen. So when this happens, you always see that the collarbone is slightly higher than the shoulder blade.
physio fitaal physiotherapy
For both a Tossy 1 and Tossy 2, it is common to use a sling for a fortnight. In addition, physiotherapy can be started to improve the function of the shoulder again. However, pain symptoms may persist for a longer period of time. Treatment consists of advice, mobilisations of the entire shoulder girdle, active exercise therapy and, last but not least, homework exercises. All this will ensure a good recovery!
Recently fallen and suffering from persistent shoulder pain? Contact us at www.fysiofitaal.nl or make an appointment directly by phone!
Operation
Sometimes a choice is still made to treat the symptoms surgically. When a previous treatment has not helped or when the severity of the injury is too great to heal naturally. During surgery, the clavicle is reattached back to the original part of the scapula. When there is recurrent instability, it is additionally attached with the hamstring tendon. The surgery is usually performed through keyhole surgery(arthroscopy). With 3 or 4 one-centimetre holes, a comprehensive look at the injury is taken and then the joint is reattached and the wounds closed.
Making an appointment at FysioFitaal
We work from multiple locations in Tilburg, always close by for professional and accessible physiotherapy. Fill in the contact form and we will contact you soon. Together, we will work on your recovery!
