title: Posterior sternoclavicular dislocation in a rugby player as a cause of silent vascular compromise: a case report.
abstract: BACKGROUND
  Approximately 120 cases of posterior sternoclavicular joint (SCJ) dislocation have been documented in the medical literature since it was first described in 1824 by Sir Astley Cooper, a statistic which underlies its relative rarity. It is associated with high energy trauma, and although it may present innocently enough, it is a potentially life threatening injury.
  
  
  RESULTS
  We describe a case in which there was no clinical evidence of complication, although CT imaging revealed complete obstruction of the brachiocephalic vein and impingement of the aorta. This required open reduction and a novel fixation technique was employed. The reduction was stable at 8 month follow up appointment as evidenced by CT scan.
  
  
  CONCLUSIONS
  We acknowledge that this type of complication is well recognised but emphasise that it should not be managed complacently. A high index of suspicion is required to determine the presence of serious complications in this type of injury, which may manifest insidiously.
authors.affiliation: University Hospitals Birmingham, Orthopaedics and Trauma, Birmingham, UK. aunmirza@hotmail.com
authors.forename: A H
authors.initials: AH
authors.lastname: Mirza
authors.forename: K
authors.initials: K
authors.lastname: Alam
authors.forename: A
authors.initials: A
authors.lastname: Ali
mesh_terms: D000328:Adult; D016121:Brachiocephalic Veins / Q000293:injuries / Q000601:surgery; D003251:Constriction, Pathologic / Q000209:etiology; D005500:Follow-Up Studies; D005538:Football / Q000293:injuries*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D012783:Shoulder Dislocation / Q000150:complications / Q000601:surgery*; D013247:Sternoclavicular Joint / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome