title: Posterior sternoclavicular epiphyseal fracture-dislocation with delayed diagnosis.
abstract: Posterior sternoclavicular joint dislocations and epiphyseal fractures are relatively rare injuries. We present a case report of a 16-year-old male who presented with a 10-day delay in diagnosis. The medial clavicular fragment was widely displaced and rested against the cervical vertebral body. Despite the degree of displacement, the patient had very few symptoms, and the diagnosis was not appreciated in the emergency department and became apparent at 10-day clinic follow-up. Treatment consisted of attempts at closed reduction, which were not successful. Open reduction was performed and the repair done with strong sutures. At 1-year follow-up the patient is doing well without any symptoms. A literature review consisting of anatomy, ossification patterns, classification systems, diagnosis and associated symptoms, imaging recommendations, treatment recommendations, outcomes, and complications is included.
authors.affiliation: Division of Pediatric Orthopaedics, Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0165, USA. kdcarmic@utmb.edu
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Carmichael
authors.forename: Anthony
authors.initials: A
authors.lastname: Longo
authors.forename: Scott
authors.initials: S
authors.lastname: Lick
authors.forename: Leonard
authors.initials: L
authors.lastname: Swischuk
mesh_terms: D000293:Adolescent; D001490:Basketball / Q000293:injuries*; D004838:Epiphyses / Q000293:injuries*; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D013247:Sternoclavicular Joint / Q000293:injuries*; D014057:Tomography, X-Ray Computed