The AC joint capsule is a thin fibrous sleeve enclosing the acromioclavicular joint, reinforced by the superior acromioclavicular ligament on its superior surface and the inferior acromioclavicular ligament below.
Maintains the AC joint, provides the primary horizontal stability of the clavicle on the acromion, and is the first structure injured in Grade I-II AC joint sprains.
AC joint capsule injury produces the spectrum of AC separations. Grade I involves capsular sprain only, Grade II adds AC ligament tear, and Grade III-VI involve coracoclavicular ligament disruption. The AC joint capsule is incised in distal clavicle resection and in hook plate removal surgery.
AC joint capsular injury without ligamentous disruption producing superior shoulder tenderness but no radiographic displacement, managed conservatively.
The AC joint capsule is repaired along with CC ligament reconstruction in Grade III-V AC separations to restore both horizontal and vertical stability.
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