- 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.
C.A. Rockwood MD. JBJS Vol 79-A, No 3, March 1997. p 387.
Short-Term Outcomes After Surgical Treatment of Traumatic Posterior Sternoclavicular Fracture-Dislocations in Children and Adolescents.
