Best Practice Case Studies-Case 153 Asset 4 AC Joint, SC Joint, and Clavicle Injuries

Video Transcription

Video Summary

The lecture reviewed key pearls on sternoclavicular (SC) joint injuries, acromioclavicular (AC) joint injuries, and clavicle fractures for sports medicine fellows. It emphasized that posterior SC dislocations are rare but emergent because of nearby vascular and airway structures; acute concern warrants urgent CT imaging and immediate surgical consultation. An illustrative case showed a posterior SC physeal injury in a 17-year-old football player that required emergency reduction and ORIF.<br /><br />For AC joint injuries, the talk covered anatomy, exam maneuvers, and Rockwood classification. Type 1–2 injuries are usually treated nonoperatively with a sling, rest, and early gentle range of motion; type 3 remains controversial and often starts with conservative care; types 4–6 generally require surgical referral. The axillary view is essential to identify posterior displacement in type 4 injuries. Weighted stress views were discouraged as they rarely change management and may increase pain.<br /><br />Clavicle fractures were also reviewed. Midshaft fractures are most common and usually treated conservatively if nondisplaced, while distal clavicle fractures, especially unstable ones involving the coracoclavicular ligaments, may need surgery. Surgical referral is indicated for marked displacement or shortening, skin tenting, neurovascular compromise, open fractures, and floating shoulder injuries. The session focused on practical diagnosis, imaging choices, and when to involve surgeons.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 153

Topic Shoulder

Keywords

4th Edition

4th Edition, Case 153

Shoulder

sternoclavicular joint injury

posterior SC dislocation

acromioclavicular joint injury

Rockwood classification

clavicle fracture

posterior displacement

CT imaging

surgical referral

sports medicine