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Sternoclavicular Joint Injury

- See: Adolescent SC Joint Injury

- Anterior SC Dislocation:
    - more common than posterior dislocation;
    - closed reduction is usually not successful;
    - persistent prominence is usually present but not of functional significance;
    - atraumatic dislocation:
           - no specific treatment is required, as the natural history is relatively good;
    - traumatic dislocation: some patients may have pain and loss of function;

- Posterior SC Dislocation:
    - rare injury;
    - medial end of the clavicle cannot be palpated;
    - be aware that soft tissue swelling may cause the false impression of an anterior dislocation;
    - may cause delayed venous congestion or tracheal erosion;
    - attempts should be made at closed reduction which are successful in many cases;
    - if closed reduction fails, then operative intervention is warrented;

- Radiographs: 40 deg cephalic tilt view;

- CT Scan: most reliable test to determine subluxation;

- Resection Arthroplasty:
    - after making an oblique skin incision over the SC joint, the periosteum is carefully elevated off the joint;
    - an oblique osteotomy is made (proximal-lateral to distal medial), w/ the osteotomy being made medial to the costoclavicualr ligaments;
    - it is essential to preserve the costoclavicular ligament inorder to maintain stability of the medial portion of the clavicle in relation to the manubrium and to the first rib;
    - hazards:
            - superior displacement and instability of the medial clavicle

Resection Arthroplasty of the Sternoclavicular Joint.   

Short-Term Outcomes After Surgical Treatment of Traumatic Posterior Sternoclavicular Fracture-Dislocations in Children and Adolescents.

Femoral and lower costosternal junctions' osteitis in an adult with SAPHO syndrome: An unusual presentation.

Biomechanical analysis of reconstructions for sternoclavicular joint instability.

Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint.

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