I have a patient who came to me after falling off his snowmobile and
struck the superior aspect of the shoulder girdle. His main complaint
now is of pain along the length of the clavicle at 90 degrees
glenohumeral flexion. The pain gets no worse as he performs full range
flexion. Horizontal adduction causes minimal discomfort. X-rays,
arthrogram all -ve. Movements that lead to posterior rotation of the
clavicle (depression, retraction, medial rotation of humerus) cause the
pain. Acromioclavicular joint is tender on palpation. Everything else
seems fine including conoid and trapezoid ligaments. Suggestions for
treatment would be much appreciated and what are the possibilities for
injured structure? Thanks in anticipation Catherine
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