A rare case of complicated pure posterior sternoclavicular dislocation in a young athlete Sternoclavicular dislocation in adolescent

Main Article Content

Filippo Calderazzi https://orcid.org/0000-0002-9087-5147
Margherita Menozzi https://orcid.org/0000-0003-1303-3453
Piergiulio Valenti
Alessandra Colacicco
Paolo Bastia
Francesco Pogliacomi
Francesco Ceccarelli

Keywords

Sternoclavicular dislocation; Adolescent; Surgery

Abstract

Sternoclavicular joint dislocation (SCJD) is a rare injury, generally classified in anterior and posterior. The posterior SCJD is very infrequent yet potentially associated with life-threatening complications. In patients with unfused medial clavicle physis, SCJD can be associated with fracture-dislocation (Salter type I or II).


We hereby present the case of a 12- year-old basketball player with severe pain in sternoclavicular region and arising dysphagia after a fall and tackle by another player. A SCJ injury was hypothesised and the CT scan detected the presence of a true posterior SCJD with no associated fracture, which was also confirmed during open reduction. As the patient complained dysphagia, it was also necessary to study other possible mediastinal compressions by a contrast medium CT scan of the great vessels.


The CT scanned brachiocephalic vein compression without additional clinical evidence or signs. Twenty hours after the trauma the patient underwent an unsuccessful closed reduction; for this reason, surgical treatment with open reduction and fixation was mandatory. After 12 weeks of therapy she returned to her previous sport activity.

Downloads

Download data is not yet available.
Abstract 177 | PDF Downloads 118

References

1. Lee JT, Nasreddine AY, Black EM, Bae DS, Kocher MS. Posterior sternoclavicular joint injuries in skeletally
immature patients. J Pediatr Orthop. 2014 Jun;34(4):369-75.
2. Dhawan R, Singh RA, Tins B, Hay SM. Sternoclavicular joint. Shoulder Elbow. 2018 Oct;10(4):296-305.
3. Sernandez H, Riehl J. Sternoclavicular Joint Dislocation: A Systematic Review and Meta-analysis. J Orthop Trauma. 2019 Jul;33(7):e251-e255.
4. Adamcik S, Ahler M, Gioutsos K, Schmid RA, Kocher GJ. Repair of sternoclavicular joint dislocations with FiberWire®. Arch Orthop Trauma Surg. 2017 Mar;137(3):341-345
5. Laffosse JM, Espié A, Bonnevialle N, Mansat P, Tricoire JL, Bonnevialle P, Chiron P, Puget J. Posterior dislocation of the sternoclavicular joint and epiphyseal disruption of the medial clavicle with posterior displacement in sports participants. J Bone Joint Surg Br. 2010 Jan;92(1):103-9
6. Kirby JC, Edwards E, Kamali Moaveni A. Management and functional outcomes following sternoclavicular joint dislocation. Injury. 2015 Oct;46(10):1906-13.
7. Robinson CM, Jenkins PJ, Markham PE, Beggs I. Disorders of the sternoclavicular joint. J Bone Joint Surg Br 2008;90(6):685–96.
8. Sewell MD, Al-Hadithy N, Le Leu A, Lambert SM. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes. Bone Joint J. 2013 Jun;95-B(6):721-31.
9. Tepolt F, Carry PM, Heyn PC, Miller NH. Posterior sternoclavicular joint injuries in the adolescent population: a meta-analysis. Am J Sports Med. 2014 Oct;42(10):2517-24
10. Groh GI, Wirth MA, Rockwood CA Jr. Treatment of traumatic posterior sternoclavicular dislocations. J Shoulder Elbow Surg. 2011;20:107–113.
11. Garg S, Alshameeri ZA, Wallace WA. Posterior sternoclavicular joint dislocation in a child: a case report with review of literature. J Shoulder Elbow Surg. 2012 Mar;21(3):e11-6.
12. Cruz MF, Erdeljac J, Williams R, Brown M, Bolgla L. Posterior sternoclavicular joint dislocation in a division football player: a case report. Int J Sports Phys Ther. 2015 Oct;10(5):700-11.
13. Abiddin Z, Sinopidis C, Grocock CJ, Yin Q, Frostick SP. Suture anchors for treatment of sternoclavicular joint instability. J Shoulder Elbow Surg. 2006 May-Jun;15(3):315-8. doi: 10.1016/j.jse.2005.07.005. PMID: 16679231.
14. Leighton RK, Buhr AJ, Sinclair AM. Posterior sternoclavicular dislocations. Can J Surg 1986;29:104-6.
15. Deren ME, Behrens SB, Vopat BG, Blaine TA. Posterior sternoclavicular dislocations: a brief review and technique for closed management of a rare but serious injury. Orthop Rev (Pavia). 2014 Mar 12;6(1):5245.
16. Glass ER, Thompson JD, Cole PA, Gause TM 2nd, Altman GT. Treatment of sternoclavicular joint dislocations: a systematic review of 251 dislocations in 24 case series. J Trauma. 2011 May;70(5):1294-8.
17. Gilot GJ, Wirth MA, Rockwood CA. Injuries to the sternoclavicular joint. In: Rockwood CA, Green DP, editors. Fracture in adults. Sixth edition. Philadelphia: Lippincott William & Wilkins; 2006. p. 1363-97
18. Gobet R, Meuli M, Altermatt S, Jenni V, Willi UV. Medial clavicular epiphysiolysis in children: The so-called sterno-clavicular dislocation. Emerg Radiol 2004;10:252-5.
19. Waters PM, Bae DS, Kadiyala RK. Short-term outcomes after surgical treatment of traumatic posterior sternoclavicular fracture-dislocations in children and adolescents. J Pediatr Orthop. 2003 Jul-Aug;23(4):464-9.
20. Lampasi M, Bochicchio V, Bettuzzi C, Donzelli O. Sternoclavicular physeal fracture associated with adjacent clavicle fracture in a 14-year-old boy: a case report and literature review. Knee Surg Sports Traumatol Arthrosc. 2008 Jul;16(7):699-702.
21. Martin SD, Altchek D, Erlanger S. Atraumatic posterior dislocation of the sternoclavicular joint: a case-report and literature-review. Clin Orthop Relat Res. 1993;292:159-164.
22. Medvecky MJ, Zuckerman JD. Sternoclavicular joint injuries and disorders. Instr Course Lect 2000;49:397–406.
23. Bontempo NA, Mazzocca AD. Biomechanics and treatment of acromioclavicular and sternoclavicular joint injuries. Br J Sports Med. 2010 Apr;44(5):361-9. doi: 10.1136/bjsm.2009.059295. PMID: 20371562.
24. Morell DJ, Thyagarajan DS. Sternoclavicular joint dislocation and its management: A review of the literature. World J Orthop. 2016 Apr 18;7(4):244-50.
25. Lunseth PA, Chapman KW, Frankel VH. Surgical treatment of chronic dislocation of the sterno-clavicular joint. J Bone Joint Surg Br. 1975 May;57(2):193-6. PMID: 1141285.
26. Burrows HJ. Tenodesis of subclavius in the treatment of recurrent dislocation of the sterno-clavicular joint. J Bone Joint Surg Br. 1951 May;33B(2):240-3. PMID: 14832323.
27. Castropil W, Ramadan LB, Bitar AC, Schor B, de Oliveira D'Elia C. Sternoclavicular dislocation--reconstruction with semitendinosus tendon autograft: a case report. Knee Surg Sports Traumatol Arthrosc. 2008 Sep;16(9):865-8. doi: 10.1007/s00167-008-0527-9. Epub 2008 Apr 17. PMID: 18418578.
28. Armstrong AL, Dias JJ. Reconstruction for instability of the sternoclavicular joint using the tendon of the sternocleidomastoid muscle. J Bone Joint Surg Br. 2008 May;90(5):610-3.
29. Shuler FD, Pappas N. Treatment of posterior sternoclavicular dislocation with locking plate osteosynthesis. Orthopedics. 2008 Mar;31(3):273.
30. Gerich T, Hoffmann A, Backes F, Duinslaeger AD, Seil R, Pape D. Anterior buttress plate is successful for treating posterior sterno-clavicular dislocation. Knee Surg Sports Traumatol Arthrosc. 2019 Jan;27(1):251-258.
31. Franck WM, Jannasch O, Siassi M, Hennig FF. Balser plate stabilization: an alternate therapy for traumatic sternoclavicular instability. J Shoulder Elbow Surg. 2003 May-Jun;12(3):276-81.

Most read articles by the same author(s)

1 2 3 4 5 6 7 > >>