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AC Dislocations, SC Dislocations, and Scapula Fractures

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The Pediatric Upper Extremity
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Abstract

Fractures and dislocations about the shoulder girdle are commonly seen in the pediatric population. This chapter discusses scapula fractures, acromioclavicular dislocations, and sternoclavicular dislocations in children and adolescents. The epidemiology, pathoanatomy, assessment, diagnosis, and treatment options of these injuries are discussed. The chapter will include data from the limited number of pediatric studies on these topics as well as data extrapolated from the adult literature.

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References

  • Ada JR, Miller ME. Scapula fracture. Analysis of 113 cases. Clin Orthop Relat Res. 1991;269:174–80.

    PubMed  Google Scholar 

  • Allman Jr FL. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am. 1967;49:774–84.

    PubMed  Google Scholar 

  • An HS, Vonderbrink JP, Ebraheim NA, et al. Open scapulothoracic disassociation with intact neurovascular status in a child. J Orthop Trauma. 1988;2:36–8.

    Article  CAS  PubMed  Google Scholar 

  • Anavian J, Wijdicks CA, Schroder LK, Vang S, Cole PA. Surgery for scapula process fractures. Acta Orthop. 2009;80:344–50.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bae DS, Kocher MS, Waters PM, et al. Chronic recurrent anterior sternoclavicular joint instability: results of surgical management. J Pediatr Orthop. 2006;26:71–4.

    Article  PubMed  Google Scholar 

  • Bahk MS, Kuhn JE, Galatz LM, Connor PM, Williams Jr GR. Acromioclavicular and sternoclavicular injuries and clavicular, glenoid, and scapular fractures. J Bone Joint Surg Am. 2009;91:2492–510.

    PubMed  Google Scholar 

  • Bannister GC, Wallace WA, Stableforth PG, Hutson MA. The management of acute acromioclavicular dislocation: a randomized prospective controlled trial. J Bone Joint Surg Br. 1989;71:848–50.

    CAS  PubMed  Google Scholar 

  • Baumann M, Vogel T, Weise K, Muratore T, Trobisch P. Bilateral posterior sternoclavicular dislocation. Orthopedics. 2010;33:510.

    PubMed  Google Scholar 

  • Bearden JM, Hughston JC, Whatley GS. Acromioclavicular dislocation: method of treatment. J Sports Med. 1973;1:5–17.

    Article  CAS  PubMed  Google Scholar 

  • Bergfield JA, Andrish JT, Clancy WG. Evaluation of the acromioclavicular joint following first- and second-degree sprains. Am J Sports Med. 1978;6:153–9.

    Article  Google Scholar 

  • Boldin C, Frankhauser F, Ratschek M, Haller-Schober EM. Foreign-body reaction after reconstruction of complete acromioclavicular dislocation using PDS augmentation. J Shoulder Elbow Surg. 2004;12:99–100.

    Article  Google Scholar 

  • Bosworth BM. Acromioclavicular separation: new method of repair. Surg Gynecol Obstet. 1941;73:866–71.

    Google Scholar 

  • Buckerfield CT, Castle ME. Acute traumatic retrosternal dislocation of the clavicle. J Bone Joint Surg Am. 1984;66:379–85.

    CAS  PubMed  Google Scholar 

  • Bullock DP, Koval KJ, Moen KY, Carney BT, Spratt KF. Hospitalized cases of child abuse in America: who, what, when, and where. J Pediatr Orthop. 2009;29:231–7.

    Article  PubMed  Google Scholar 

  • Burrows HJ. Tenodesis of subclavius in the treatment of recurrent dislocation of the sterno-clavicualr joint. J Bone Joint Surg Br. 1951;33B:240–3.

    CAS  PubMed  Google Scholar 

  • Cave EF. Fractures and other injuries. Chicago: Year Book Medical Publishers; 1958.

    Google Scholar 

  • Corteen DP, Teitge RA. Stabilization of the clavicle after distal resection: a biomechanical study. Am J Sports Med. 2005;33:61–7.

    Article  PubMed  Google Scholar 

  • Dameron TB, Rockwood Jr CA. Fractures and dislocations of the shoulder. In: Rockwood Jr CA, editor. Fractures in children. Philadelphia: J.B. Lippincott; 1984. p. 577–682.

    Google Scholar 

  • de Jong KP, Sukul DM. Anterior sternoclavicular dislocation: a long-term follow-up study. J Orthop Trauma. 1990;4:420–3.

    Article  PubMed  Google Scholar 

  • Edwards SG, Whittle AP, Wood 2nd GW. Nonoperative treatment of ipsilateral fractures of the scapula and clavicle. J Bone Joint Surg Am. 2000;82:774–80.

    Article  CAS  PubMed  Google Scholar 

  • Ferraz IC, Papadimitriou NG, Sotereanos DG. Scapular body nonunion: a case report. J Shoulder Elbow Surg. 2002;11:98–100.

    Article  PubMed  Google Scholar 

  • Flatow EL. The biomechanics of the acromioclavicular, sternoclavicular, and scapulothoracic joints. Instr Course Lect. 1993;42:237–45.

    CAS  PubMed  Google Scholar 

  • Fukuda K, Craig EV, An KN, Cofield RH, Chao EY. Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am. 1986;68:434–40.

    CAS  PubMed  Google Scholar 

  • Goldfarb CA, Bassett GS, Sullivan S, et al. Retrosternal displacement after physeal fracture of the medial clavicle in children treatment by open reduction and internal fixation. J Bone Joint Surg Br. 2001;83:1168–72.

    Article  CAS  PubMed  Google Scholar 

  • Goss TP. Fractures of the glenoid cavity. J Bone Joint Surg Am. 1992;74:299–305.

    CAS  PubMed  Google Scholar 

  • Goss TP. Fractures of the glenoid neck. J Shoulder Elbow Surg. 1994;3:42–52.

    Article  CAS  PubMed  Google Scholar 

  • Goss TP. Scapular fractures and dislocations: diagnosis and treatment. J Am Acad Orthop Surg. 1995;3:22–33.

    PubMed  Google Scholar 

  • Groh GI, Wirth MA. Management of traumatic sternoclavicular injuries. J Am Acad Orthop Surg. 2011;19:1–7.

    PubMed  Google Scholar 

  • Groh GI, Wirth MA, Rockwood Jr CA. Treatment of traumatic posterior sternoclavicular joint dislocations. J Shoulder Elbow Surg. 2011;20:107–13.

    Article  PubMed  Google Scholar 

  • Heining CF. Retrosternal dislocation of the clavicle: early recognition, x-ray diagnosis, and management [abstract]. J Bone Joint Surg Am. 1967;50:830.

    Google Scholar 

  • Hobbs DW. Sternoclavicular joint: a new axial radiographic view. Radiology. 1968;90:801.

    Article  CAS  PubMed  Google Scholar 

  • Ideberg R, Grevsten S, Larsson S. Epidemiology of scapular fractures. Incidence and classification of 338 fractures. Acta Orthop Scand. 1995;66:395–7.

    Article  CAS  PubMed  Google Scholar 

  • Imatani RJ. Fractures of the scapula: a review of 53 fractures. J Trauma. 1975;15:473–8.

    Article  CAS  PubMed  Google Scholar 

  • Jaggard MK, Gupte CM, Gulati V, Reilly P. A comprehensive review of trauma and disruption to the sternoclavicular joint with the proposal of a new classification system. J Trauma. 2009;66:576–84.

    Article  PubMed  Google Scholar 

  • Jones HP, Lemos MJ, Schepsis AA. Salvage of failed acromioclavicular joint reconstruction using autogenous semitendinosus tendon from the knee: surgical technique and case report. Am J Sports Med. 2001;29:234–7.

    CAS  PubMed  Google Scholar 

  • Kaplan LD, Flanigan DC, Norwig J, Jost P, Bradley J. Prevalence and variance of shoulder injuries in elite collegiate football players. Am J Sports Med. 2005;33:1142–6.

    Article  PubMed  Google Scholar 

  • Kavanagh BF, Bradway JK, Cofield RH. Open reduction and internal fixation of displaced intra-articular fractures of the glenoid fossa. J Bone Joint Surg Am. 1993;75:479–84.

    CAS  PubMed  Google Scholar 

  • Koch MJ, Wells L. Proximal clavicle physeal fracture with posterior displacement: diagnosis, treatment, and prevention. Orthopedics. 2012;35:e108–11.

    PubMed  Google Scholar 

  • Labler L, Platz A, Weishaupt D, Trentz O. Clinical and functional results after floating shoulder injuries. J Trauma. 2004;57:595–602.

    Article  PubMed  Google Scholar 

  • Leighton RK, Buhr AJ, Sinclair AM. Posterior sternoclavicular dislocations. Can J Surg. 1986;29:104–6.

    CAS  PubMed  Google Scholar 

  • Lyons FA, Rockwood Jr CA. Migration of pins used in operations on the shoulder. J Bone Joint Surg Am. 1990;72:1262–7.

    CAS  PubMed  Google Scholar 

  • Martin SD, Weiland AJ. Missed scapular fracture after trauma. A case report and a 23-year follow-up report. Clin Orthop Relat Res. 1994;299:259–62.

    PubMed  Google Scholar 

  • Mayo KA, Benirschke SK, Mast JW. Displaced fractures of the glenoid fossa. Results of open reduction and internal fixation. Clin Orthop Relat Res. 1998;347:122–30.

    Article  PubMed  Google Scholar 

  • Mazzocca AD, Santangelo SA, Johnson ST, Rios CG, Dumonski ML, Arciero RA. A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med. 2006;34:236–46.

    Article  PubMed  Google Scholar 

  • McGahan JP, Rab GT, Dublin A. Fractures of the scapula. J Trauma. 1980;20:880–3.

    Article  CAS  PubMed  Google Scholar 

  • Michael D, Fazal MA, Cohen B. Nonunion of a fracture of the body of the scapula: case report and literature review. J Shoulder Elbow Surg. 2001;10:385–6.

    Article  CAS  PubMed  Google Scholar 

  • Mounshine E, Garofalo R, Crevoisier X, Farron A. Grade I and II acromioclavicular dislocations: results of conservative treatment. J Shoulder Elbow Surg. 2003;12:599–602.

    Article  Google Scholar 

  • Nettles JL, Linscheid RL. Sternoclavicular dislocations. J Trauma. 1968;8:158–64.

    Article  CAS  PubMed  Google Scholar 

  • Nettrour LF, Krufky EL, Mueller RE, et al. Locked scapula: intrathoracic dislocation of the inferior angle. A case report. J Bone Joint Surg Am. 1972;54:413–6.

    CAS  PubMed  Google Scholar 

  • Nordqvist A, Petersson C. Fracture of the body, neck, or spine of the scapula. A long-term follow-up study. Clin Orthop Rel Res. 1992;283:139–44.

    Google Scholar 

  • Phillips AM, Smart C, Groom AF. Acromioclavicular dislocation: conservative or surgical therapy. Clin Orthop Relat Res. 1998;353:10–7.

    Article  PubMed  Google Scholar 

  • Reilly P, Bruguera JA, Copeland SA. Erosion and nonunion of the first rib after sternoclavicular reconstruction with Dacron. J Shoulder Elbow Surg. 1999;8:76–8.

    Article  CAS  PubMed  Google Scholar 

  • Rockwood CAJR, Williams Jr GR, Young DC. Disorders of the acromioclavicular joint. In: Rockwood CA, Matsen FA, editors. The shoulder. Philadelphia: WB Saunders; 1998. p. 483–553.

    Google Scholar 

  • Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner JP. Acromioclavicular joint injuries: diagnosis and management. J Am Acad Orthop Surg. 2009;17:207–19.

    PubMed  Google Scholar 

  • Spencer Jr EE, Kuhn JE. Biomechanical analysis of reconstructions for sternoclavicular joint instability. J Bone Joint Surg Am. 2004;86:98–105.

    PubMed  Google Scholar 

  • Spencer EE, Kuhn JE, Huston LJ, et al. Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. J Shoulder Elbow Surg. 2002;11:43–7.

    Article  PubMed  Google Scholar 

  • Stewart AM, Ahmad CS. Failure of acromioclavicular reconstruction using Gore-Tex graft due to aseptic foreign-body reaction and clavicle osteolysis: a case report. J Shoulder Elbow Surg. 2004;13:558–61.

    Article  PubMed  Google Scholar 

  • Sugaya H, Kon Y, Tsuchiya A. Arthroscopic repair of glenoid fractures using suture anchors. Arthroscopy. 2005;21:635.

    PubMed  Google Scholar 

  • Thompson DA, Flynn C, Miller PW, Fischer RP. The significance of scapular fractures. J Trauma. 1985;25:974–7.

    Article  CAS  PubMed  Google Scholar 

  • Tompkins M, Bliss J, Villarreal R, Solga P. Posterior-sternoclavicular disruption with ipsilateral clavicle fracture in a nine-year-old hockey player. J Orthop Trauma. 2010;24:e36–9.

    Article  PubMed  Google Scholar 

  • Tossy JD, Mead MC, Sigmond HM. Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop Relat Res. 1963;28:111–9.

    CAS  PubMed  Google Scholar 

  • Venissac N, Alifano M, Dahan M, et al. Intrathoracic migration of Kirschner pins. Ann Thorac Surg. 2000;69:1953–5.

    Article  CAS  PubMed  Google Scholar 

  • Waters PM, Bae DS, Kadiyala RK. Short-term outcomes after surgical treatment of traumatic posterior sternoclavicula fracture-dislocations in children and adolescents. J Pediatr Orthop. 2003;23:464–9.

    PubMed  Google Scholar 

  • Williams Jr GR, Nguyen VD, Rockwood Jr CA. Classification and radiographic analysis of acromioclavicular dislocations. Appl Radiol. 1989;18:29–34.

    Google Scholar 

  • Wirth MA, Rockwood Jr CA. Acute and chronic traumatic injuries of the sternoclavicular joint. J Am Acad Orthop Surg. 1996;4:268–78.

    PubMed  Google Scholar 

  • Wojtys EM, Nelson G. Conservative treatment of grade III acromioclavicular dislocations. Clin Orthop Relat Res. 1991;268:112–9.

    PubMed  Google Scholar 

  • Zanca P. Shoulder pain: involvement of the acromioclavicular joint: analysis of 1,000 cases. Am J Roentgenol Radium Ther Nucl Med. 1971;112:493–506.

    Article  CAS  PubMed  Google Scholar 

  • Zdravkovic D, Damholt VV. Comminuted and severely displaced fractures of the scapula. Acta Orthop Scand. 1974;45:60–5.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Brandon S. Schwartz .

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Schwartz, B.S., Pensy, R., Eglseder, W.A., Abzug, J.M. (2015). AC Dislocations, SC Dislocations, and Scapula Fractures. In: Abzug, J., Kozin, S., Zlotolow, D. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8515-5_66

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  • DOI: https://doi.org/10.1007/978-1-4614-8515-5_66

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8513-1

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