Sternoclavicular Joint Dislocation

Sternoclavicular (SC) joint dislocation refers to the displacement of the clavicle (collarbone) from its normal position at the sternoclavicular joint, where the clavicle meets the sternum (breastbone). This joint is critical for shoulder movement and stability, as it anchors the clavicle to the sternum, allowing the upper limb to have a wide range of motion.

Types of Sternoclavicular Joint Dislocation

Anterior Dislocation

- The clavicle is displaced forward, in front of the sternum.
- This is the most common type of SC joint dislocation and is generally less serious.
- It can often be treated conservatively with rest, immobilization, and physical therapy.

Posterior Dislocation

- The clavicle is displaced backward, behind the sternum.
- This type is rarer but more dangerous due to the proximity of vital structures behind the clavicle, such as the trachea, esophagus, and major blood vessels.
- Posterior dislocations often require more urgent medical attention and sometimes surgical intervention.

Causes

– Trauma: A direct blow to the shoulder, such as from a car accident or contact sports, is the most common cause. The force can push the clavicle out of place.

– Indirect Trauma: Falling on an outstretched arm or receiving a blow to the lateral shoulder can indirectly force the clavicle to dislocate.

Symptoms

– Pain and Swelling: Severe pain at the joint, swelling, and bruising.
– Visible Deformity: An obvious bump or depression over the joint (especially in anterior dislocations).

– Limited Range of Motion: Difficulty or pain when moving the shoulder or arm.
– Difficulty Breathing or Swallowing: In posterior dislocations, there might be symptoms like shortness of breath, difficulty swallowing, or a sense of fullness in the throat due to pressure on the surrounding structures.

Diagnosis

– Physical Examination: A doctor will assess the shoulder for pain, deformity, and range of motion.

– Imaging: X-rays, CT scans, or MRI may be needed to confirm the diagnosis and assess the extent of the injury.

Treatment

Conservative Management:
– For anterior dislocations: Reduction (realignment of the joint) under local or general anesthesia, followed by immobilization with a sling or figure-of-eight bandage.
– Physical therapy is important after immobilization to restore full range of motion and strength.

Surgical Intervention:
– Typically reserved for posterior dislocations or when conservative management fails.
– The procedure may involve open reduction and internal fixation (ORIF) or reconstruction of the ligaments if they are severely damaged.

Complications

– Recurrent Dislocation: Especially if the ligaments are not adequately healed or repaired.
– Chronic Pain and Instability: May occur if the joint does not heal properly.

– Injury to Nearby Structures: Especially in posterior dislocations, which can affect the trachea, esophagus, and major blood vessels.

Prognosis

With appropriate treatment, many people recover fully from a sternoclavicular joint dislocation, although recovery time can vary

depending on the severity of the dislocation and the treatment method used. In some cases, especially with posterior dislocations, there may be residual instability or pain.

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