Which AC joint sprain type involves rupture of the deltotrapezial fascia with the clavicle palpable through the skin and elevated?

Which AC joint sprain type involves rupture of the deltotrapezial fascia with the clavicle palpable through the skin and elevated?

• A. Type 5
• B. Type 6
• C. Type 1
• D. Type 3

Answer: (A)

The key idea is recognizing a high-grade AC joint injury where the soft-tissue envelope is torn and the distal clavicle is markedly displaced. In severe AC separations, rupture of the deltoid–trapezial fascia allows the clavicle to elevate dramatically and even be palpable beneath the skin—a sign known as skin tenting. This combination is classic for a Rockwood Type V AC separation, which features complete rupture of the AC and coracoclavicular ligaments with a markedly increased clavicle elevation and deltoid–trapezial fascia disruption. Type VI involves the clavicle displacing inferiorly under the coracoid or acromion, which isn’t described here, and Type III is a less severe dislocation without the pronounced fascia rupture and skin tenting. Types I and II are minor sprains with little to no deformity. So the presentation aligns with a Type V AC joint injury.

The key idea is recognizing a high-grade AC joint injury where the soft-tissue envelope is torn and the distal clavicle is markedly displaced. In severe AC separations, rupture of the deltoid–trapezial fascia allows the clavicle to elevate dramatically and even be palpable beneath the skin—a sign known as skin tenting. This combination is classic for a Rockwood Type V AC separation, which features complete rupture of the AC and coracoclavicular ligaments with a markedly increased clavicle elevation and deltoid–trapezial fascia disruption. Type VI involves the clavicle displacing inferiorly under the coracoid or acromion, which isn’t described here, and Type III is a less severe dislocation without the pronounced fascia rupture and skin tenting. Types I and II are minor sprains with little to no deformity. So the presentation aligns with a Type V AC joint injury.