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Case Reports
. 2023 Jan 9:43:100766.
doi: 10.1016/j.tcr.2023.100766. eCollection 2023 Feb.

Posterior sternoclavicular joint dislocation with thoracic costovertebral joints fracture-dislocations: A case report

Affiliations
Case Reports

Posterior sternoclavicular joint dislocation with thoracic costovertebral joints fracture-dislocations: A case report

Hiroshi Takahashi et al. Trauma Case Rep. .

Abstract

Case: A 59-year-old man presented with posterior sternoclavicular joint dislocation concomitant with fracture-dislocations of multiple thoracic costovertebral joints caused by traumatic injury. The posterior sternoclavicular joint dislocation was treated using an ultra-high molecular weight polyethylene fiber cable and the joint was stabilized. The degree of malpositioning of the thoracic costovertebral joints was difficult to reduce.

Conclusion: The patient achieved an excellent shoulder range of motion at 12 months postoperatively; however, chronic shoulder stiffness and posterior neck discomfort persisted.

Keywords: NESPLON Cable System; Posterior sternoclavicular joint dislocation; Thoracic costovertebral joints fracture-dislocations; Ultra-high molecular weight polyethylene fiber cable.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Radiographs (A) indicating the dislocations of thoracic costovertebral joints (arrowheads) and right hemothorax. Computed tomography (CT) examination revealed right posterior sternoclavicular joint dislocation (arrows), and fracture dislocations of the right 1st–5th ribs costovertebral joints (arrowheads). B and C are three-dimensional CT and D is axial plane CT.
Fig. 2
Fig. 2
A: A curved skin incision of approximately 7 cm was made in the anterior thoracic region. B: Both posterior dislocation of the sternoclavicular joint and the first sternocostal joint and the gap between the first costal cartilage and manubrium are shown. C: Protecting the posterior part of the manubrium using the cement spatula during drilling is shown. Asterisk: medical clavicle, star: manubrium, triangle: first costal cartilage.
Fig. 3
Fig. 3
A: The figure-of-eight weaving procedure with a 5 mm diameter ultra-high molecular weight polyethylene fiber cable is shown. B: The procedure of weaving through the hole while protecting the posterior part of the manubrium using the finger of the operator is shown. C: The stabilization of the sternoclavicular joint and first sternocostal joint is shown. Asterisk: medical clavicle, star: manubrium, triangle: first costal cartilage.
Fig. 4
Fig. 4
A: Computed tomography examination revealed the repositioning of the right posterior sternoclavicular joint (arrows). B: The degree of malposition of thoracic costovertebral joints could not be reduced (arrowheads).

References

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