There is clearly persistent cranial displacement of the distal clavicle by 100% or nearly 100% of the shafts width at the ACJ with chronic capsular disruption
The clavicle overrides the acromion and is slightly posterior to the ACJ in the Sag images (white arrow)
The yellow arrow indicates the thickened and somewhat bright coracoclavicular ligament—without a focal fluid signal defect at this time
I have been confused by cases like this before….as the injury is chronic and I don’t know if the Rockwood and Green (or other) classification systems are relevant.
To the extent that Class IIIb or IV would warrant surgery, I am confused how this would be classified.
I don’t see protrusion of the clavicle through the trapezius fascia…but there is the cranial and posterior displacement….and there has been injury to the coracoclavicular ligament.
Thoughts?
Thanks.
Hilary
