Instability and Degenerative Arthritis of the Sternoclavicular Joint

Abstract

Injuries to the SC joint are uncommon. Recognition and classification of these injuries are critical to proper management, thus minimizing potential long-term sequelae such as posttraumatic arthritis and recurrent instability. Although nonoperative therapy is the modality of choice in anterior dislocations, posterior dislocations require special attention because of the presence of vulnerable posterior hilar structures. Surgical management of chronic instability and degenerative arthritis of the SC joint includes resection arthroplasty of the medial clavicle with or without reconstruction of the sternoclavicular ligaments with graft material. Although resection is typically performed open, an arthroscopic technique is described that theoretically decreases operating and recovery times while also decreasing the risk of iatrogenic injury. Currently, when reconstruction is needed for stability, a figure-of-8 graft reconstruction is the recommended method based on biomechanical data and small clinical series.

Management and functional outcomes following sternoclavicular joint dislocation

“…Right-hand-sided injury occurred in 12 patients (54.5%). All dislocations were of Allman type 3, meaning they were all true dislocations rather than sprains (type 1) or subluxations (type 2) [22]. The mean age was 30 years (range 16-65) and the male-to-female ratio was 4.5:1.…”

Nonunion of the First Sternocostal Synchondrosis Accompanied by Sternoclavicular Joint Synovitis

“…His symptoms immediately improved by half. Based on this observation, the synovitis could have been secondary to the instability due to nonunion of the first sternocostal synchondrosis, since the clavicle, manubrium, and the first costal cartilage constitute the joint's articulation through being connected by the intra-articular ligament [12, 13]. Some authors have reported that CT is useful for diagnosing first rib injury [11, 14, 15].…”

Injuries of the Sternoclavicular Joint - An Innovative Approach in the Management of a Rare Injury: Tight Rope Fixation of the Costo-Clavicular Ligament

“…On the other hand, the question of the type of reconstruction arises, which can in principle be achieved by means of a filament-augmentation of the ligament residues by seams or by replacing them with autologous tendon transplantation (24). The latter always entail a risk of complications at the donorsite of the tendons, which are widely known in the context of other ligament reconstructions such as at the knee or the ankle (25).…”