The Hip: Preservation, Replacement and Revision

Adolescent Sternoclavicular Joint Injury

- 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.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, January 3, 2013 3:28 pm