Posterior Sternoclavicular Dislocations: A Brief Review and Technique for Closed Management of a Rare But Serious Injury
The patient is an 18 year-old male college student with no past medical history who presented with severe pain, difficulty swallowing, and decreased range of motion of his right shoulder after he was driven to the ground playing rugby. He was seen at the emergency department and presented for a second opinion for sternoclavicular joint injury. Radiographs and CT scan were performed and demonstrated a posterior superior sternoclavicular dislocation (). On exam, there was significant tenderness localizing over the right SCJ as well as an obvious deformity with less prominence of the joint on the right as compared to the left. He was neurovascularly intact. Radiographs of the right shoulder demonstrated SCJ asymmetry on the right as compared to the left, and MRI demonstrated a superior and posterior SCJ dislocation.\nThe patient was scheduled for urgent closed reduction within 24 hours, and underwent closed reduction of the right posterior SCJ dislocation by the technique described 3 days post injury confirmed by radiographs (). At twelve weeks, the patient had no complaints, and the joint was stable on exam. Radiographs demonstrated no change in position of the SCJ, with slight superior and anterior displacement (). He returned to sports 6 months post injury without difficulty ().