Grade 3 AC Separation

Shoulder separations are classified in terms of severity by a grading system. The worse the injury the higher the grade. A grade 1 or grade 2 injury is a non-displaced or partially displaced joint. All other grades represent different levels of severity of a complete AC Joint separation. A grade 3 AC Separation is the most common injury.

Do I have a Grade 3 AC Separation?

Grade 3 AC Joint Separation measured x-rayDiagnosing a grade 3 AC separation requires a simple x-ray of both the injured and the uninjured side. The distance between the clavicle and the coracoid process (a part of the scapula) is measured. If the x-ray is digital then this distance can be measured with greater precision and accuracy. If the distance between the two bones is at least 25% increased relative to the normal side but less than 100% (double the distance) then the injury is considered to be a grade3 shoulder separation.

Grade 3 Shoulder Separation x-rayNon-surgical treatment is often recommended as the initial treatment for this level of severity while immediate surgery is recommended when the injury is more severe. While this is a logical approach, new research suggests that this distinction may be arbitrary, especially because there is no clear evidence that the severity of a complete dislocation has prognostic significance and the grading process itself is subject to errors in x-ray positioning, surgeon differences, and frequent failure to use digital criteria. The initial treatment decision, therefore, is based on many factors to be considered, the injury grade being one of many.