The mechanism of injury is usually direct trauma to the acromioclavicular joint from a fall with the arm adducted, as typically may occur in a sporting activity. An indirect mechanism is a fall on the outstretched hand with transmission of force to the acromioclavicular joint. The result is that the scapula and shoulder girdle are driven inferiorly while the clavicle remains in its normal position. This is confirmed by observing the opposite clavicle, which is at the same level as the injured one.
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