Best Practice Case Studies-Sternoclavicular Joint Dislocation

Pdf Summary

The article authored by Daniel J Morell and David S Thyagarajan is a comprehensive review of sternoclavicular joint (SCJ) dislocation and its management. The SCJ, crucial for its role in connecting the upper extremity to the axial skeleton, is inherently unstable due to its limited articular contact, making it susceptible to dislocation. Dislocations are classified into anterior and posterior, with anterior dislocations being more common but posterior dislocations posing serious threats due to potential neurovascular, tracheal, and esophageal injuries.<br /><br />The article emphasizes the challenges in diagnosing and managing SCJ dislocations due primarily to their rarity and complexity. It explains that traditional x-rays often fail to provide clear images of these injuries, leading to CT scans being the preferred diagnostic tool. Management strategies vary based on the type and severity of the dislocation. Anterior dislocations can often be treated non-surgically, although persistent instability might require surgical intervention. By contrast, posterior dislocations demand urgent reduction due to the risk of severe complications.<br /><br />The authors also discuss various surgical techniques for SCJ stabilization, ranging from the utilization of tendon grafts to modern approaches like the introduction of braided polyester mesh devices. The manuscript critiques historical techniques, notably discouraging the use of pin transfixation due to high associated risks, including cardiac damage and death.<br /><br />Moreover, the article introduces the concept of the "floating clavicle," an injury involving simultaneous dislocation at both the SCJ and acromioclavicular joint, necessitating individually tailored treatment plans due to its rarity. Overall, the review highlights the importance of accurate diagnosis and appropriate treatment of SCJ dislocations to prevent long-term complications while advocating for surgical management to be conducted in specialized centers equipped to handle potential complications.

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Edition 3rd Edition

Related Case 3rd Edition, CASE 10

Topic Chest

Keywords

3rd Edition, CASE 10

3rd Edition

Chest

sternoclavicular joint

SCJ dislocation

anterior dislocation

posterior dislocation

CT scans

surgical techniques

floating clavicle

tendon grafts

braided polyester mesh

specialized centers