Sternoclavicular dislocation is a rare shoulder injury caused by a hard blow to the shoulder. Symptoms include severe pain and shoulder deformity. Treatment may involve closed reduction or surgery. Posterior dislocations can be more dangerous as they can damage important structures below the breastbone.
Sternoclavicular dislocation is a type of injury in which the clavicle, or clavicle, separates from its attachment to the breastbone or sternum. This could be caused by a hard blow to the shoulder. A sternoclavicular dislocation is a relatively rare form of shoulder injury because the sternoclavicular joint, between the breastbone and collarbone, is reinforced by a series of strong bands of tissue called ligaments, as well as a capsule that surrounds the joint. Car accidents, sports injuries, and falls can cause sternoclavicular dislocation. If a dislocation can’t be managed by manipulating the joint back into place, surgery may be needed.
Most often, a dislocation of the sternoclavicular joint is what is known as an anterior dislocation, where the free end of the clavicle ends in front of the sternum. This is usually the result of a force applied to the front of the shoulder, rotating the shoulder backwards and tearing the collarbone away from the sternum. Posterior dislocations are less common and can be caused by a force hitting the shoulder from behind, breaking the joint and pushing the collarbone behind the breastbone. Occasionally, posterior dislocation is the result of a force directly striking the front of the clavicle and pushing it back. The risk with a posterior dislocation is that the end of the clavicle can damage important structures below the breastbone, such as the lungs, esophagus and major blood vessels.
Symptoms associated with sternoclavicular dislocation include pain, which is typically severe, and shoulder deformity. The discomfort is usually worse with a posterior dislocation, and for both anterior and posterior dislocations, moving the arm leads to increased pain. Depending on the injury, there may be symptoms, such as shortness of breath and difficulty swallowing, associated with other structures that have been damaged. In the case of an anterior dislocation, there may be a visible lump, which represents the end of the clavicle that projects forward.
Treatment of sternoclavicular dislocation may not be necessary in the case of an anterior dislocation, as some damaged joints may simply be left as they are and allowed to heal. In other cases, the so-called closed reduction can be carried out. This involves manually moving the joint into position, a procedure which may require general anesthesia due to its painful nature. Closed reduction is more likely to be successful for posterior dislocations but, if the technique fails, sternoclavicular surgery may be required to avoid future complications. Surgery allows the dislocated joint to be repositioned from the inside and pinned in place for stability.
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