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The AC joint is located on the top front of the shoulder, and connects the collar bone (clavicle) to the shoulder blade (scapula). A separated shoulder is an injury to the ligaments that cross the AC joint holding your collarbone to your shoulder blade. The most common cause for a separation of the AC joint is from a fall directly onto the shoulder. The fall injures the ligaments that surround and stabilize the AC joint.
If the force is severe enough, the ligaments attaching to the underside of the clavicle are torn. The injury is easy to identify when it causes deformity. When there is less deformity, the location of pain and X-rays help the doctor make the diagnosis. Sometimes having the patient hold a weight in the hand can increase the deformity, which makes the injury more obvious on X-rays.
Nonsurgical treatments, such as a sling, icing and medications can help control the pain. Sometimes, a doctor may use more complicated supports to help limit AC joint motion and decrease pain.
Surgery can be considered if pain persists or the deformity is severe. Where there is significant deformity, reconstructing the ligaments that attach to the underside of the collarbone is occasionally helpful.