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Sterno-Clavicular Joint Dislocation
Related Subjects: |Shoulder Anterior Dislocations |Shoulder: Posterior Dislocation |Shoulder: Sterno-Clavicular Joint Dislocation |Shoulder:Posterior Dislocation |Elbow Dislocation |Olecranon Fracture |Distal Humerus Fracture |Radial Head and Neck Fractures |Forearm Fractures |Shaft of Ulna Fracture |Wrist Colles Fracture |Wrist Smith’s Fracture
Introduction
The sterno-clavicular (SC) joint connects the sternum (breastbone) to the clavicle (collarbone). Dislocations of this joint, though rare, can be classified into anterior and posterior types. Prompt diagnosis and management are crucial due to the risk of associated complications, especially with posterior dislocations that may involve critical structures like the great vessels.
Diagnosis
The diagnosis of a sterno-clavicular joint dislocation is often made through imaging, specifically a chest X-ray , which can help assess joint asymmetry. Clinical examination is vital to differentiate the type of dislocation (anterior or posterior).
Clinical Examination
- Anterior Dislocation: The clavicle is more prominent on palpation over the anterior chest wall. This is usually the less concerning type and can often be managed conservatively.
- Posterior Dislocation: There is a palpable depression on the anterior chest wall. This type of dislocation may be more serious, as it can potentially involve the trachea, oesophagus, or great vessels.
Management depending on the type:
- Anterior Dislocation: The condition can generally be managed conservatively with a broad arm sling to immobilize the joint. Follow-up in a fracture clinic is essential for monitoring recovery.
- Posterior Dislocation: This requires immediate attention. If suspected, an ECG should be performed to rule out involvement of the heart or great vessels. Referral to the on-call orthopaedic team is necessary for further evaluation and management.
Conclusion
- Although sterno-clavicular joint dislocations are uncommon, their diagnosis and management are important for ensuring proper healing and preventing complications.
- Accurate diagnosis through chest X-ray and thorough clinical examination can help differentiate the type of dislocation, guiding appropriate treatment.
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