The Anatomy of the Sternoclavicular Joint
• Diarthrodial Joint
• “Saddle shaped”
• Poor congruence
• Intra-articular disc
...
• Interclavicular ligament- Connects the
superomedial aspects of each clavicle with the
capsular ligaments and the upper s...
Epiphysis of the Medial Clavicle
• Medial Physis- Last of the ossification centers
to appear in the body and the last epip...
Injuries Associated with
Sternoclavicular Joint Dislocations
• Mediastinal
Compression
• Pneumothorax
• Laceration of the
...
Treatment of Anterior Sternoclavicular
Dislocations
• Nonoperative treatment
• Analgesics and immobilization
• Functional ...
Treatment of Posterior
Sternoclavicular Dislocations
• Careful examination of the patient is
extremely important to rule o...
• Abduction traction
• Adduction traction
• “Towel Clip” - anterior force applied to
clavicle by percutaneously applied to...
• Resection arthroplasty
–May result in instability of remaining
clavicle unless stabilization is done.
–Suggest minimal r...
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Sternoclavicular joint injuries

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Sternoclavicular joint injuries

  1. 1. The Anatomy of the Sternoclavicular Joint • Diarthrodial Joint • “Saddle shaped” • Poor congruence • Intra-articular disc ligament. Divides SC joint into two separate joint spaces. • Costoclavicular ligament- (rhomboid ligament) Short and strong and consist of an anterior and posterior fasciculus
  2. 2. • Interclavicular ligament- Connects the superomedial aspects of each clavicle with the capsular ligaments and the upper sternum • Capsular ligament- Covers the anterior and posterior aspects of the joint and represents thickenings of the joint capsule. The anterior portion of the ligament is heavier and stronger than the posterior portion.
  3. 3. Epiphysis of the Medial Clavicle • Medial Physis- Last of the ossification centers to appear in the body and the last epiphysis to close. • Does not ossify until 18th to 20th year • Does not unite with the clavicle until the 23rd to 25th year
  4. 4. Injuries Associated with Sternoclavicular Joint Dislocations • Mediastinal Compression • Pneumothorax • Laceration of the superior vena cava • Tracheal erosion
  5. 5. Treatment of Anterior Sternoclavicular Dislocations • Nonoperative treatment • Analgesics and immobilization • Functional outcome usually good • Closed reduction • Often not successful • Direct pressure over the medial end of the clavicle may reduce the joint
  6. 6. Treatment of Posterior Sternoclavicular Dislocations • Careful examination of the patient is extremely important to rule out vascular compromise. • Consider CT to rule out mediastinal compression • Attempt closed reduction - it is often successful and remains stable.
  7. 7. • Abduction traction • Adduction traction • “Towel Clip” - anterior force applied to clavicle by percutaneously applied towel clip Closed Reduction Techniques
  8. 8. • Resection arthroplasty –May result in instability of remaining clavicle unless stabilization is done. –Suggest minimal resection of bone and fixation of medial clavicle to first rib. • Sternoclavicular reconstruction with suture, tendon graft. Operative Techniques
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