Management of sternoclavicular dislocation in young children: considerations about diagnosis and treatment of four cases

Albarova, Jorge Gil; Rebollo-González, S.; Gómez-Palacio, Victoria Eugenia; Herrera, Antonio

doi:10.1007/s12306-012-0240-1

Cited by 21 publications

(19 citation statements)

References 23 publications

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“…In a series of 4 pediatric patients, 2 patients had irreducible anterior dislocations that required an open reduction and were then stabilized via a figure-of-8 suture passed through clavicular and sternal bone tunnels. 7 Both patients were stable at 2 years after surgery.…”

Section: Discussionmentioning

confidence: 84%

Treatment of First-Time Traumatic Anterior Dislocation of the Sternoclavicular Joint With Surgical Repair of the Anterior Capsule Augmented With Internal Bracing

Tytherleigh-Strong

Pecheva

Titchener

2018

Orthopaedic Journal of Sports Medicine

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Background:Traumatic anterior dislocations of the sternoclavicular joint (SCJ) are rare. Although they can usually be treated by a closed reduction, the reported subsequent recurrence rate is 50%.Purpose:To determine whether further instability after first-time traumatic anterior dislocation would be prevented by a minimally invasive open repair of the anterior SCJ capsule, augmented with internal bracing.Study Design:Case series; Level of evidence, 4.Methods:Open repair of the anterior SCJ capsule was completed on a series of patients who had sustained a first-time traumatic anterior dislocation of the SCJ. Patients with preexisting SCJ instability and recurrent dislocations were excluded. Through a transverse incision, the anterior SCJ capsule was repaired and plicated by use of sutures. The repair was then protected by use of an internal brace, bridging between the sternum and the medial end of the clavicle.Results:Six patients (4 males, 2 females) with a mean age of 28.3 years were included. Four patients underwent surgery within 4 weeks of their dislocation, and 2 patients had ongoing symptoms of instability but had not had a further dislocation. The median follow-up was 28.2 months (range, 24-35 months). At the most recent follow-up, none of the patients had sustained further dislocation or episode of instability, and their SCJs appeared stable. The mean abbreviated Disabilities of the Arm, Shoulder and Hand (QuickDASH) score was 2.3 (range, 0-4.5).Conclusion:The medium-term results of this case series suggest that after first-time dislocation, surgical repair of the anterior SCJ capsule augmented with internal bracing can prevent recurrent instability. This may be an attractive option for individuals involved in higher risk activities, as the operative management of recurrent anterior SCJ instability usually requires a figure-of-8 tendon reconstruction, which carries a significantly higher morbidity.

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Section: Discussionmentioning

confidence: 84%

Treatment of First-Time Traumatic Anterior Dislocation of the Sternoclavicular Joint With Surgical Repair of the Anterior Capsule Augmented With Internal Bracing

Tytherleigh-Strong

Pecheva

Titchener

2018

Orthopaedic Journal of Sports Medicine

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“…The Rockwood (Serendipity) view [8] [9] is an AP view centred on the manubrium with 40˚ cephalad tilt and taken with the patient supine on the X-ray cassette. With this view there is good visualisation of both sternoclavicular joints [10] [11] and by inference the medial clavicle, although there are no studies to compare it to standard AP views in the imaging of clavicle fractures. The Heinig view [12] of the medial clavicle is a tangential view of the sternoclavicular joint, which again is quoted in sternoclavicular joint injuries but there is no mention of it in the literature with regards to medial clavicle fractures.…”

Section: Discussionmentioning

confidence: 99%

Radiography of Clavicle Fractures— A Review of the Literature —Do Various Radiographic Views of Clavicle Fractures Affect the Management Plan?

Baraza¹,

Wood²

2014

OJRad

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Introduction: Fractures of the clavicle are common and make up 5%-10% of all fractures. Treatment options in part depend on the location of the fracture along the bone and degree of displacement. These two parameters are best determined by good quality, standardized radiographs of the clavicle. We reviewed the literature to determine the optimal radiographs of clavicle fractures and their influence on the treatment plan. Methods: A comprehensive search of Medline™ database was undertaken with the following search terms and MeSH headings: clavicle, fractures, bone, radiography, and X-ray. We included articles in English published from 1950 to present. We ruled out fractures in children, fracture dislocations, open fractures, those with neurological and vascular injuries and fractures involving the acromioclavicular or sternoclavicular joints. Findings: Of the 821 citations obtained, only four studies proved eligible. In the most pertinent, four orthopaedic surgeons were shown standard views (antero-posterior and 20˚ cephalic tilt) of 50 clavicle fractures and then additional two views (45˚ cephalic and caudal tilt), and found that alternative views influenced their decision making, with more surgeons opting for surgical fixation. In a different study, it was shown that orthogonal views of the clavicle increased surgeons' understanding and improved their treatment of these fractures. The third paper was a case series on clavicle fractures that were missed on the initial antero-posterior radiograph, and the fourth paper postulated that postero-anterior views of the thorax were most accurate in determining length of the clavicle. Conclusion: Studies showing an optimal view for assessment of clavicle fractures with a decision to then progressing to operative fixation are few, but the evidence points towards surgical fixation when alternative views of mid-shaft clavicle fractures are present.

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“… 29 Closed reduction can be attempted in most patients. 64 This is, however, likely to dislocate due to instability and frequently needs subsequent surgical management. 60 Asymptomatic subluxations do not require surgical intervention.…”

Section: Traumatic Injuries To the Sternoclavicular Jointmentioning

confidence: 99%

“… 60 Asymptomatic subluxations do not require surgical intervention. 64 Surgical stabilization can be performed using vicryl® sling, free tendon graft or a non-absorbable suture material anchored to the first rib.…”

Section: Traumatic Injuries To the Sternoclavicular Jointmentioning

confidence: 99%

Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies

et al. 2018

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The sternoclavicular joint (SCJ) is an integral part of the shoulder girdle that connects the upper limb to the axial skeleton.Swelling of the SCJ is commonly due to trauma, degeneration, infections and other disease processes that affect synovial joints.This review also focuses on uncommon conditions that could affect the SCJ, including SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome, Friedrich’s disease and Tietze syndrome.The scope of this review is limited to the analysis of the current evidence on the various conditions affecting the SCJ and also to provide an algorithm to manage these conditions.Cite this article: EFORT Open Rev 2018;3:471-484. DOI: 10.1302/2058-5241.3.170078

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Management of sternoclavicular dislocation in young children: considerations about diagnosis and treatment of four cases

Cited by 21 publications

References 23 publications

Treatment of First-Time Traumatic Anterior Dislocation of the Sternoclavicular Joint With Surgical Repair of the Anterior Capsule Augmented With Internal Bracing

Treatment of First-Time Traumatic Anterior Dislocation of the Sternoclavicular Joint With Surgical Repair of the Anterior Capsule Augmented With Internal Bracing

Radiography of Clavicle Fractures— A Review of the Literature —Do Various Radiographic Views of Clavicle Fractures Affect the Management Plan?

Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies

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