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AC Shoulder Separation


Shoulder Separations is different from shoulder dislocations, and represents an injury to the joint between the Clavicle (Collar bone) and the Acromion bone (the tip of the shoulder blade). 

Most often Shoulder Separations occur from a fall directly on the tip of the shoulder blade, but it can also occur from a fall onto the elbow pushing up onto the shoulder.



Typically, the patient will have pain on the top of the shoulder, especially with movement of the arm.  If it is severe enough, the shoulder may appear disfigured as if there is a bump or a high-riding clavicle bone.  Movement of the shoulder and sleeping on the affected shoulder can cause significant pain.


Diagnostic Testing

Usually Dr. Steven Lee will start with an xray to help determine the grade of injury as well as to help rule out other diagnoses such as fractures.  If needed, he may order additional radiologic studies such as an MRI or CAT Scan. 



The treatment depends on a number of factors such as the grade/severity of the injury as well as patient factors such as age, activity level, and hand dominance.  Those patients who are Grade 1, 2, and 3 (especially those who are older or less active) can often be treated with a simple sling for up to 6 weeks, pain medicines if needed, and physical therapy.


Those patients who are grade 4, 5, or 6, or have an open wound or skin that appears to be severely tented will typically be recommended surgery.  Also, those patients with lesser grades who have continued symptoms despite nonoperative treatment may also opt to have surgery.  Some patients may opt for surgery for cosmetic reasons.


Dr. Steven Lee has literally pioneered the modern surgical treatment for shoulder separations, and is one of the world’s leading experts on this diagnosis.  He has written 5 landmark research papers and has lectured around the country on the topic.  Previous treatments prior to Dr. Lee’s research had unacceptably high failure rates.  His research led to a reconstruction that utilizes a tendon graft that is Internally Braced, and that is now considered the gold standard utilized by most orthopaedic surgeons today.  Learn more about scheduling surgery.

Recovery Expectations

After surgery, Dr. Lee will typically recommend a sling to be worn full time for approximately 6 weeks.  During this time it is important not to lift or carry anything more than a pound, and also not to extend the shoulder backwards.  After 6 weeks, physical therapy will be recommended, which continues for up to 3 months.  Full use of the shoulder typically takes 4-6 months.  


Immediate Post-Operative Instructions

Please refer to the following pages for more information:


*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables.  It is provided as an educational service and is not intended to serve as medical advice.  Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.

*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.  

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