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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Sternoclavicular Joint Injury


- See: Adolescent SC Joint Injury

- Anterior SC Dislocation:
    - more common than posterior dislocation;
    - closed reduction is usually not successful;
    - persistent prominence is usually present but not of functional significance;
    - atraumatic dislocation:
           - no specific treatment is required, as the natural history is relatively good;
    - traumatic dislocation: some patients may have pain and loss of function;

- Posterior SC Dislocation:
    - rare injury;
    - medial end of the clavicle cannot be palpated;
    - be aware that soft tissue swelling may cause the false impression of an anterior dislocation;
    - may cause delayed venous congestion or tracheal erosion;
    - attempts should be made at closed reduction which are successful in many cases;
    - if closed reduction fails, then operative intervention is warrented;

- Radiographs: 40 deg cephalic tilt view;

- CT Scan: most reliable test to determine subluxation;

- Resection Arthroplasty:
    - after making an oblique skin incision over the SC joint, the periosteum is carefully elevated off the joint;
    - an oblique osteotomy is made (proximal-lateral to distal medial), w/ the osteotomy being made medial to the costoclavicualr ligaments;
    - it is essential to preserve the costoclavicular ligament inorder to maintain stability of the medial portion of the clavicle in relation to the manubrium and to the first rib;
    - hazards:
            - superior displacement and instability of the medial clavicle



Resection Arthroplasty of the Sternoclavicular Joint.   

Short-Term Outcomes After Surgical Treatment of Traumatic Posterior Sternoclavicular Fracture-Dislocations in Children and Adolescents.

Femoral and lower costosternal junctions' osteitis in an adult with SAPHO syndrome: An unusual presentation.

Biomechanical analysis of reconstructions for sternoclavicular joint instability.

Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint.



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

Last updated by Data Trace Staff on Thursday, January 3, 2013 3:32 pm