Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;47(5):1399-1406.
doi: 10.1007/s00068-019-01178-2. Epub 2019 Jul 1.

Injuries of the sternoclavicular region indicate concomitant lesions and need distinguished imaging

Tobias Helfen  1 , Stephan Jansen  2 , Evi Fleischhacker  3 , Wolfgang Böcker  3 , Stefan Wirth  4 , Ben Ockert  3
Affiliations

Injuries of the sternoclavicular region indicate concomitant lesions and need distinguished imaging

Tobias Helfen et al. Eur J Trauma Emerg Surg. 2021 Oct.

Abstract

Purpose: To evaluate injuries of the sternoclavicular region as indicator injury for relevant concomitant injuries and to evaluate the modalities of initial imaging. We hypothesised a high incidence of concomitant injuries as well as a deficiency of X-ray as the initial gold standard.

Methods: We retrospectively analysed patients suffering from injuries of the sternoclavicular region between 2002 and 2017. We analysed amongst injury type and severity, initial imaging (X-ray vs. CT scan of the sternoclavicular region vs. whole-body scan), and complement of imaging with regard to defined concomitant injury localisations and the resulting necessity and urgency of surgery.

Results: We included n = 61 patients. The mean ISS was 13.5 ± 17, n = 13 (21.3%) cases were classified as "severely injured" (ISS ≥ 16). N = 29 (47.5%) achieved an initial X-ray, n = 10 (16.4%) an initial CT scan of the sternoclavicular region, and n = 22 (36%) an initial whole-body CT scan. Initial imaging correlated significantly with ISS. In n = 21 (72.4%) cases of the X-ray group a significant complement from X-ray to CT scan of the sternoclavicular region was indicated (p ≤ 0.001). N = 31 (50.8%) patients suffered from concomitant injuries. N = 39 (63.9%) of all patients underwent any kind of surgery, thereof n = 23 (37.7%) related to their sternoclavicular injuries.

Conclusion: Injuries of the sternoclavicular complex are indicators for the presence of multiple injuries. A CT scan of the sternoclavicular region including ipsilateral apex of the lung and upper rib cage comprised a large proportion of concomitant injuries. Mapping those injuries during initial imaging improves treatment process, avoids underdiagnostic, and decreases uncertainties.

Keywords: CT scan; Concomitant injuries; ISS; Severely injured; Sternoclavicular injuries; Trauma; X-ray.

PubMed Disclaimer

References

    1. Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elb Surg. 2002;11(5):452–6. - DOI
    1. Kirby JC, Edwards E, Kamali Moaveni A. Management and functional outcomes following sternoclavicular joint dislocation. Injury. 2015;46(10):1906–13. - DOI
    1. Banerjee R, Waterman B, Padalecki J, Robertson W. Management of distal clavicle fractures. J Am Acad Orthop Surg. 2011;19(7):392–401. - DOI
    1. 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;70(5):1294–8.
    1. McIntosh AL. Surgical treatment of adolescent clavicle fractures: results and complications. J Pediatr Orthop. 2016;36(Suppl 1):S41–3. - DOI

LinkOut - more resources