الفهرس 
AbstrAct
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Abstract
Acromioclavicular (ac) joint disruptions are very common occurring in more than 10% of shoulder injuries and are caused by direct or indirect trauma.
The AC joint is stabilized by the joint capsule, the acromioclavicular ligament that enhances the transverse stability, and the coracoclavicular ligament, which is composed of the lateral trapezoid and the medial conoid part. The trapezoid ligament is the primary restraint against posterior clavicular displacement and also provides resistance against superior, inferior, and anterior forces. The conoid ligament is the main restraint against anterior or superior displacement of the clavicle, but also against rotation of the bone anteriorly or posteriorly. Together both ligaments plays an important role in suspending upper limb reflecting the importance of its repair or reconstruction.
Two muscles are attached to the scapular spine and acromion: the trapezius and the deltoid muscle.
The current status in diagnosing acromioclavicular joint instability is based on clinical examination and plain radiography. Additionally, a stress view is usually necessary. The well-known grading of AC joint injuries is classified according to Rockwood et al. Their classification includes three more rare types of AC joint derangements than the Tossy classification. Diagnosis of the real extent of injuries of the coracoclavicular and acromioclavicular ligaments can be expected with the established examination methods.
Untreated cases with complete AC dislocation may lead to major disability and one of the reported disabilities is traction neuropathy of the brachial plexus reflecting the importance of its reduction and stabilization.
More than 36 treatment modalities already have been established for AC dislocation. Neither treatment is satisfied to the surgeon or the patient. Conservative treatment restricted to type I and acute cases of type II and selective cases of type III While surgical treatment is applied to most of type III thru VI.
There is a wide range of controversy between authors about the way of CC ligament repair or reconstruction starting from closed reduction without its repair up to dynamic transfer and augmentation.
Also the way of AC fixation is a matter of debate; K wires, screw and plate. All are with or without CC repair or reconstruction.
Intra-articular and extra-articular fixation are relatively new and reliable method for treatment AC dislocation. Its reports of usage increase in number with time allover the world with least recorded complications or failure. It allows all normal motion of clavicle in relation to the scapula while neutralizing the forces around AC joint till healing of CC ligament occurs.