Skip to main content
SpringerLink
Log in

Sternoclavicular Joint Injuries

  • Chapter
  • First Online:
Clavicle Injuries

  • 896 Accesses

Abstract

Sternoclavicular joint injuries account for <3% of all traumatic joint injuries. Proper recognition and treatment are vital because these injuries may be life threatening. Injuries are organized by patient age, degree (subluxation, dislocation), timing (acute, chronic, recurrent), direction (anterior, posterior), and cause (traumatic, atraumatic).

Anterior injuries are far more common than posterior injuries. Anterior injuries are generally well tolerated and rarely require surgical reconstruction. Posterior dislocation may be associated with complications such as dyspnea, dysphagia, cyanosis, and swelling of the ipsilateral extremity as well as paresthesia associated with compression of the trachea, esophagus, or great vessels. These life-threatening complications may present at the time of injury but can develop later, as well.

Radiography has been largely supplanted by CT for evaluation of this injury although an oblique view developed by Wirth and Rockwood is useful in evaluating isolated sternoclavicular injury. MRI is useful in differentiating physeal injury from sternoclavicular dislocation in patients aged <23 years. Surgical indications and techniques continue to evolve; however, reconstruction of the sternoclavicular joint with a figure-eight graft has shown good results with short-term follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cave EF. Fractures and other injuries. Chicago: Year Book; 1958.

    Google Scholar 

  2. Webb PAO, Suchey JMM. Epiphyseal union of the anterior iliac crest and medial clavicle in a modern multiracial sample of American males and females. Am J Phys Anthropol. 1985;68:457–66.

    Article  CAS  PubMed  Google Scholar 

  3. Bearn JG. Direct observations on the function of the capsule of the sternoclavicular joint in clavicular support. J Anat. 1967;101:159–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Mehta JC, Sachdev A, Collins JJ. Retrosternal dislocation of the clavicle. Injury. 1973;5:79–83.

    Article  CAS  PubMed  Google Scholar 

  5. Hening CF. Retrosternal dislocation of the clavicle: early recognition, xray diagnosis and management. J Bone Joint Surg Am. 1968;50:830.

    Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  7. Waskowitz WJ. Disruption of the sternoclavicular joint: an analysis and review. Am J Orthop. 1961;3:176–9.

    Google Scholar 

  8. Omer GE. Osteotomy of the clavicle in surgical reduction of anterior sternoclavicular dislocation. J Trauma. 1967;7:584–90.

    Article  PubMed  Google Scholar 

  9. Hiramuro-Shoji F, Wirth MA, and Rockwood CA. Jr. Atraumatic conditions of the sternoclavicular joint. J Shoulder Elbow Surg. 2003;12:79–88 doi:10.1067/mse.2003.128566.

  10. Wirth MA, Rockwood CA. Disorders of the sternoclavicular joint. In: Rockwood CA, Matsen FA, Wirth MA, Lippitt SB, editors. The shoulder. Philadelphia: Saunders. p. 527–60.

    Google Scholar 

  11. Rockwood Jr CA, Odor JM. Spontaneous atraumatic anterior subluxation of the sternoclavicular joint. J Bone Joint Surg Am. 1989;71:1280–6.

    Article  PubMed  Google Scholar 

  12. Sabatini JB, et al. Outcomes of augmented allograft figure of eight sternoclavicular joint reconstruction. J Shoulder Elbow Surg. 2015;24:902–907.

    Google Scholar 

  13. Fery A, Sommelet J. Dislocation of the sternoclavicular joint: a review of 49 cases. Int Orthop. 1988;12:187–95.

    Article  CAS  PubMed  Google Scholar 

  14. de Jong KP, Sukul DM. Anterior sternoclavicular dislocation: a long-term follw-up study. J Orthop Trauma. 1988;4:420–3.

    Article  Google Scholar 

  15. Thut D, Hergan D, Dukas A, Day M, Sherman OH. Sternoclavicular joint reconstruction—a systematic review. Bull NYU Hosp Jt Dis. 2011;69:128–35.

    PubMed  Google Scholar 

  16. Bicos J, Nicholson GP. Treatment and results of sternoclavicular joint injuries. Clin Sports Med. 2003;22:359–70.

    Article  PubMed  Google Scholar 

  17. Kibler WB, Sciascia A. Current concepts: scapular dyskinesis. Br J Sports Med. 2010;44:300–5. doi:10.1136/bjsm.2009.058834.

  18. Bankart ASB. An operation for recurrent dislocation (subluxation) of the sternoclavicular joint. Br J Surg. 1938;26:320–3.

    Article  Google Scholar 

  19. Key JA, Conwell HE. The management of fracture, dislocations, and sprains. 5th ed. St. Louis: CV Mosby; 1951. p. 458–61.

    Google Scholar 

  20. Burrows HJ. Tenodesis of subclavis in the treatment of recurrent dislocation of the sternoclavicular joint. J Bone Joint Surg Br. 1951;33:240–3.

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  22. Kawaguchi K, Tanaka S, Yoshitomi H, Nagai I, Sato W, Karita T, et al. Double figure-of-eight reconstruction technique for chronic anterior sternoclavicular joint dislocation. Knee Surg Sports Traumatol Arthrosc. 2014; doi:10.1007/s00167-014-2979-4.

    PubMed  Google Scholar 

  23. Bak K, Fogh K. Reconstruction of the chronic anterior unstable sternoclavicular joint using a tendon autograft: medium-term to long-term follow-up results. J Shoulder Elbow Surg. 2014;23:245–50. doi:10.1016/j.jse.2013.05.010.

    Article  PubMed  Google Scholar 

  24. Gaines RJ, Liporace FA, Yoon RS, DeMaio M. A novel technique for ligamentous reconstruction of the sternoclavicular joint. J Orthop Trauma. 2014;28:e65–9. doi:10.1097/BOT.0b013e31829aa9c5.

    Article  PubMed  Google Scholar 

  25. Uri O, Barmpagiannis K, Higgs D, Falworth M, Alexander S, Lambert SM. Clinical outcome after reconstruction for sternoclavicular joint instability using a sternocleidomastoid tendon graft. J Bone Joint Surg Am. 2014;96:417–22. doi:10.2106/JBJS.M.00681.

    Article  PubMed  Google Scholar 

  26. Groh GI, Wirth MA, Rockwood CA. Treatment of traumatic posterior sternoclavicular joint injuries. J Shoulder Elbow Surg. 2011; doi:10.1016/j.jse.2010.03.009.

    Google Scholar 

  27. Buckerfield CT, Castle ME. Acute traumatic retrosternal dislocation of the clavicle. J Bone Joint Surg Am. 1984;66:379–84.

    Article  CAS  PubMed  Google Scholar 

  28. Rockwood CA, Groh GI, Wirth MA, Grassi FA. Resection arthroplasty of the sternoclavicular joint. J Bone Joint Surg Am. 1997;79:387–93.

    Article  PubMed  Google Scholar 

  29. Wirth MA, Rockwood CA. Complications following repair of the sternoclavicular joint. In: Bigliani LU, editor. Complications of the shoulder. Baltimore: Williams & Wilkins; 1993. p. 139–53.

    Google Scholar 

  30. Brown JE. Anterior sternoclavicular dislocation—a method of repair. Am J Orthop. 1961;31:184–9.

    Google Scholar 

  31. Eskola A, Vainionpaa S, Vastamaki M, et al. Operation for older sternoclavicular dislocation. Results in 12 cases. J Bone Joint Surg Br. 1989;71:53–5.

    Google Scholar 

  32. Lunseth PA, Chapmen KW, Frankel VJ. Surgical treatment of chronic dislocation of the sternoclavicular joint. J Bone Joint Surg Br. 1975;57:193–6.

    CAS  PubMed  Google Scholar 

  33. Ge O. Osteotomy of the clavicle in surgical reduction of anterior sternoclavicular dislocation. J Trauma. 1967;7:584–90.

    Article  Google Scholar 

  34. Groh GI, Wirth MA. Management of traumatic sternoclavicular joint injuries. J Am Acad Orthop Surg. 2010;19(1):1–7.

    Article  Google Scholar 

  35. Clark RI, Milgram JW, Yawn DH. Fatal aortic perforation and cardiac tamponade due to a Kirshner wire migrating from the right sternoclavicular joint. South Med J. 1974;67:316–8.

    Article  CAS  PubMed  Google Scholar 

  36. Gerlach D, Wemhoner SR, Ogbuihi S. On two cases of fatal heart tamponade due to migration of fracture nails from the sternoclavicular joint. Z Rechtsmed. 1984;93:53–60.

    Article  CAS  PubMed  Google Scholar 

  37. Leonard JW, Gifford RW. Migration of a Kirshner wire from the clavicle into pulmonary artery. Am J Cardiol. 1965;16:598–600.

    Article  CAS  PubMed  Google Scholar 

  38. Richman KM, Boutin RD, Vaughan LM, et al. Tophaceous pseudogout of the sternoclavicular joint. AJR Am Roentgenol. 1999;172:1587–9.

    Article  CAS  Google Scholar 

  39. Smolle-Juettner FM, Hofer PH, Pinter H, et al. Intracardiac malpositioning of a sternoclavicular fixation wire. J Orthop Trauma. 1992;6:102–5.

    CAS  PubMed  Google Scholar 

  40. Worman LW, Leagus C. Intrathoracic injury following retrossternal dislocation of the clavicle. J Trauma. 1967;7:416–23.

    Article  CAS  PubMed  Google Scholar 

  41. Pate JW, Wilhite J. Migration of a foreign body from the sternocalvicular joint to the heart: a case report. Am Surg. 1969;35:448–9.

    CAS  PubMed  Google Scholar 

  42. Song HK, Sloane G, Kaiser LR, Shrager JB. Current presentation and optimal surgical management of sternoclavicular joint infections. Ann Thorac Surg. 2002;73:427–31.

    Article  PubMed  Google Scholar 

  43. Nordback I, Markkula H. Migration of Kirschner pin from clavicle into ascending aorta. Acta Chir Scand. 1985;151:177–9.

    CAS  PubMed  Google Scholar 

  44. Jelesijevic V, Knoll D, Klinke F, et al. Penetrating injuries of the heart and intrapericardial blood vessels caused by migration of a Kirshner pin after osteosynthesis. Acta Chir Iugosl. 1982;29:274.

    PubMed  Google Scholar 

  45. Liu HP, Chang CH, Lin PJ, et al. Migration of Kirshner wire for the right sternoclavicular joint into the main pulmonary Artery: a case report. Chang Gung Med J. 1992;15:49–53.

    CAS  Google Scholar 

  46. Rubenstein ZR, Moray B, Itzchak Y. Percutaneous removal on intravascular foreign bodies. Cardiovasc Intervent Radiol. 1982;5:64–8.

    Article  Google Scholar 

  47. Schechter DC, Gilbert L. Injuries of the heart and great vessels due to pins and needles. Thorax. 1969;24:246–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Sethi GK, Scott SM. Subclavian artery laceration due to migration of a Hagie pin. Surgery. 1976;80:644–6.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mission Orthopedics, Mission Health, One Hospital Drive, 28801, Asheville, NC, USA

    Gordon I. Groh M.D.

Authors
  1. Gordon I. Groh M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gordon I. Groh M.D. .

Editor information

Editors and Affiliations

  1. Mission Orthopedics, Mission Health, One Hospital Drive, Asheville, North Carolina, USA

    Gordon I. Groh

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Groh, G.I. (2018). Sternoclavicular Joint Injuries. In: Groh, G. (eds) Clavicle Injuries. Springer, Cham. https://doi.org/10.1007/978-3-319-52238-8_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-52238-8_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52236-4

  • Online ISBN: 978-3-319-52238-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation