Grade V acromioclavicular joint separation in a 57-year-old mountain biker.

Patients rarely present to a chiropractic office setting during the acute stage of a high-grade (i.e. Rockwood types IV-VI) separation of the acromioclavicular (AC) joint. Moreover, such cases are non-existent in the peer-reviewed chiropractic literature. Some controversy exists over the optimal (surgical vs. non-surgical) treatment of severe AC joint injuries. Published reports of nonoperative management for grade V injuries of the AC joint are also scarce. This case review highlights the plain film imaging and conservative management of a 57-year-old patient diagnosed with an acute Rockwood type V AC joint separation. Radiographs with nine years of follow-up are presented.