Causes and Management of Sternoclavicular Joint:
The Sternoclavicular Joint happens between the proximal end of the clavicle and the clavicular level of the manubrium of the sternum together with a little sector of the first costal fibrous.
Mechanism of Injury
This is the least commonly dislocated joint because of the strong ligaments.
- Direct force rarely causes this injury. For example, collision of an athlete with another person or a post, etc
- Indirect force is the most common mode of injury. For example, loading the upper shoulder while someone lies on the sides
- Incidence is about three percent and is more common in young males.
Causes
Road traffic accident (RTA) is responsible for 80 percent of the cases, sports-related injuries account for the remaining 20 percent.
Classifications
Anatomical classification
- Anterior dislocation (more common)
- Posterior dislocation
Etiological classification
1. Traumatic
- Sprain
- Acute dislocation
- Recurrent dislocation
- Unreduced dislocation
2. Atraumatic
- Voluntary
- Involuntary
- Congenital
- Degenerative
- Infective
Clinical Features
The patient complains of pain and swelling. Medial end of the clavicle is prominent in anterior dislocation. Affected shoulder is short. Lateral compression test is positive.
Radiographs
- AP view is often difficult to interpret.
- Special 90 degree cephalocaudal views-this helps to see the medial ends of both the clavicles (serendipity view).
- Tomograms are useful.
- CT scans and MRI help to study the position of clavicle with respect to sternum and soft tissues respectively.
Management
- Mild sprain: The treatment consists of ice, sling, painkillers, etc.
- Subluxation: The treatment methods are ice (first 12 hr), warmth (24-48 hr), clavicle strap, and figure of ’8′ and excision of medial end if pain persists.
- Dislocation: The treatment of choice is closed reduction by firm digital pressure followed by figure of ’8′, clavicle strap, sling, etc. If it fails, open reduction and internal fixation using K-wire is done.
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