Treatment of traumatic posterior sternoclavicular dislocations.
BACKGROUND
Traumatic posterior sternoclavicular joint injuries are rare, but complications are common and include brachial plexus and vascular injury, esophageal rupture, and death.


METHODS
The records of 21 patients treated at our institution for a posterior sternoclavicular injury were reviewed. All patients underwent a trial of closed reduction, which was effective in 8 patients (group I). The remaining 13 patients were treated with open reduction and sternoclavicular joint reconstruction (group II).


RESULTS
Closed reduction was more likely to be successful (P < .05) in dislocations treated within 10 days of injury. Patients were evaluated by use of the University of California, Los Angeles rating scale. Overall, 18 of 21 patients were graded as good or excellent. Patients treated with either open or closed reduction as their definitive management compared favorably in terms of ratings for pain, strength, and motion.


CONCLUSIONS
Our experience suggests that closed reduction compares favorably with open reduction. Of patients treated, 38% required only closed reduction as their definitive treatment. In this series early closed reduction was successful and obviated the risks of surgery. Patients who in whom closed reduction failed obtained good results with operative treatment aimed at reconstruction of the costoclavicular ligaments.
Groh
Gordon I
GI
Blue Ridge Bone and Joint Clinic, Asheville, NC, USA. ggroh@brbj.com
Wirth
Michael A
MA
Rockwood
Charles A
CA
D000328:Adult; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D011859:Radiography; D013247:Sternoclavicular Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014143:Traction; D016896:Treatment Outcome; D055815:Young Adult