Treatment and results of sternoclavicular joint injuries

Abstract

Sternoclavicular joint injuries are uncommon. The anatomy is not familiar to most orthopaedic surgeons, and there is a high risk of both intraoperative catastrophic and postsurgical complications when performing surgery in this region. Anterior SC joint instability should primarily be treated conservatively. The patients should be informed that there is a high risk of persistent instability with nonoperative or operative care, but that the persistent instability will be well tolerated and have little functional impact in the vast majority. Therefore, operative intervention for anterior SC joint instability is mainly cosmetic in nature. Patients with posterior SC joint dislocations require an expeditious diagnosis and treatment, due to the proximity of the displaced medial clavicle to the great vessels. An early closed reduction will usually be stable. Operative stabilization must, however, be considered if the closed reduction is unsuccessful or there is persistent SC instability. SC joint stabilization should be performed with a soft tissue reconstruction, repairing both the costoclavicular ligaments and the SC capsular envelope.