Options for treatment include placing the patient in a sling. This is usually utilized for mild cases in which the step-off in the joint is not so severe, and the CC ligaments are intact. The sling is usually used for a few weeks, which is followed by a course of physical therapy.
Surgery is reserved for the more severe shoulder separations. The surgery is an outpatient procedure which consists of a distal clavicle resection and a ligament reconstruction. During the distal clavicle resection, both ends of the AC joint are excised to allow the joint to move freely without friction. After this step is performed, a cadaveric tendon is used to reconstruct the torn ligaments to align the AC joint to its normal position. This involves making a small incision over the joint itself to allow the passage and reconstruction of the ligaments.
After surgery, a sling is placed for comfort and worn for about 4-6 weeks. Sutures are taken out one week after surgery. Physical therapy is carried out after to restore the shoulder motion and strength. Although the surgery will eliminate most of the visible bump seen on top of the shoulder, you may continue to see a small step-off between the collar bone and the shoulder blade.