You are in the causlity when a student, is brought in with a shoulder injury sustained while playing football. In comparing the symmetry of his two shoulders, you notice a marked elevation of the distal end of his clavicle with respect to the acromion on the injured side. X-ray examination reveals a grade III shoulder separation. In order for this to have occurred, which ligament must be torn?
Correct Answer: Coracoclavicular
Description: A shoulder separation is an injury to the acromioclavicular joint. A first degree separation involves stretching the ligaments, but maintenance of the joint. A second degree separation involves tearing of the joint capsule and coracoclavicular ligament, but still continuity. A third degree separation involves total disruption of the joint and the coracoclavicular ligament.Since the patient has a third degree shoulder separation, you know he must have torn his coracoclavicular ligament. The coracoacromial ligament contributes to the stability of the acromioclavicular joint, but damaging this ligament is not the hallmark of a third degree shoulder separation. The costoclavicular ligament connects the first rib to the clavicle. The superior glenohumeral ligament contributes to the stability of the shoulder joint, but not to the stability of the acromioclavicular joint. The transverse humeral ligament holds the tendon of the long head of the biceps in place in the inteubercular groove.
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