- See:
SC Joint Injury:
- Medial SC Joint Injury:
- injury is due separation of proximal clavicular physis rather than dislocation;
- need to determine if proximal clavicular metaphysis (distal fragment) is anterior or posterior;
- anterior and superior displacement of medial end of
clavicle or x-ray appearance of
SC joint
separation indicates a Salter Harris type I or type II separation of medial clavicular epiphysis;
- anterior displacement:
- require only symptomatic treatment;
- posterior displacement:
- more symptomatic, can displace vital thoracic outlet structures, and require manipulative reduction;
- Radiographs:
- medial epiphysis does not ossify on radiographs until the pt is 18 yrs, and does not fuse
until age 23-25 yrs;
- if fragment is posterior, it appears more caudad than normal side on x-rays taken w/
the beam was pointed obliquely toward the sternum in a cephalad direction;
- Treatment:
- anterior SC joint injuries typically heal satisfactorily w/ a shoulder immobolizer;
- as a periosteal sleeve or tube is maintained (adequate remodeling potential exists);
- posterior displacement in an asymptomatic adolescent should be closed reduced, & there is
little indication for open reduction;
Spontaneous atraumatic anterior subluxation of the sternoclavicular joint.
