Management and functional outcomes following sternoclavicular joint dislocation

Dynamic assessment of sternoclavicular joint instability using four‐dimensional computed tomography

“…Type 1 describes a simple sprain of the sternoclavicular ligaments; Type 2 describes disruption of the sternoclavicular ligaments and capsule resulting in subluxation but not dislocation; Type 3 describes rupture of all supporting ligaments with complete dislocation. The primary treatment for SCJ injuries is non‐operative, as surgical intervention may require extensive exposure with potential fatal complications owing to the close relationship between the SCJ and the major vasculatures as shown in Figure …”

Posterior sternoclavicular Salter-Harris fracture-dislocation in a patient with unossified medial clavicle epiphysis

“…The most common mechanism of sternoclavicular joint injury is a direct blow to the shoulder, either from a fall or during sports-related activities. Sternoclavicular injuries can occur at any age but are most common in young adults (average age 29-39 years) with a slight male predilection [2,10,11]. Typically, injuries to the sternoclavicular joint involve a varying degree of injury to the joint capsule ranging from mild capsular stretching to complete disruption.…”

“…Anterior dislocations occur more commonly than posterior dislocations with posterior dislocations being reported to comprise as much as 25-33 % of all sternoclavicular dislocations [2,13]. When they occur, posterior dislocations have been described as causing injury to mediastinal structures such as the great vessels, brachial plexus, and trachea [10,13,14]. Clinical symptoms of mediastinal compression have been described to occur in up to 25-50 % of patients presenting with posterior sternoclavicular dislocations [4,10].…”

“…When they occur, posterior dislocations have been described as causing injury to mediastinal structures such as the great vessels, brachial plexus, and trachea [10,13,14]. Clinical symptoms of mediastinal compression have been described to occur in up to 25-50 % of patients presenting with posterior sternoclavicular dislocations [4,10]. Most posterior sternoclavicular injuries will require open reduction-internal fixation, although some authors advocate attempting close reduction of all posterior sternoclavicular injuries since up to 40-50 % of these injuries can be reduced by close reduction [2,10,11].…”

“…Clinical symptoms of mediastinal compression have been described to occur in up to 25-50 % of patients presenting with posterior sternoclavicular dislocations [4,10]. Most posterior sternoclavicular injuries will require open reduction-internal fixation, although some authors advocate attempting close reduction of all posterior sternoclavicular injuries since up to 40-50 % of these injuries can be reduced by close reduction [2,10,11]. However, closed reduction of a posteriorly displaced sternoclavicular joint should only be performed in the operating room with a vascular surgeon available given the proximity of the great vessels and possibility of vascular injury [15].…”