title: Sternoclavicular Reconstruction in the Young Active Patient: Risk Factor Analysis and Clinical Outcomes at Short-Term Follow-up.
abstract: OBJECTIVE
  To determine the functional outcomes in young, active individuals after sternoclavicular (SC) joint reconstruction.
  
  
  METHODS
  Level IV, case series.
  
  
  METHODS
  United States military hospitals, 2008-2012.
  
  
  METHODS
  Retrospective review of all consecutive patients from the Military Health System Management Analysis and Reporting Tool was performed. Patients who underwent other open-shoulder procedures (eg, acromioclavicular joint reconstruction), those of nonmilitary or retired status, and patients with under 12-month minimum follow-up without medical separation were excluded from further analysis.
  
  
  METHODS
  Open reconstruction of SC joint dislocation.
  
  
  METHODS
  Primary outcomes of interest were clinical failure and medical separation due to persistent shoulder girdle dysfunction. Demographic data, surgical technique, outcomes, complications, and occupational military outcomes were recorded.
  
  
  RESULTS
  Fourteen patients, with an average age of 26 years, experienced 8 anterior (57.1%) and 6 posterior (42.9%) SC joint dislocations. Four patients (28.6%) presented with dysphagia or dyspnea, and 10 patients (71.4%) had a missed diagnosis with an average of 13 months until diagnosis. Twelve of 14 (85.7%) patients underwent figure-of-eight tendon reconstruction, and 10 (71.4%) were able to return to full active military duty at an average 26.8 ± 12.9 months follow-up. There were 6 complications in 5 patients (35.7%), whereas 2 (14.3%) reported persistent instability and 2 (14.3%) required reoperation.
  
  
  CONCLUSIONS
  SC joint dislocations are rare injuries that are frequently missed on clinical presentation in this study. However, acute or delayed surgical reconstruction may afford predictable rates of return to function in young active military service members.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center, El Paso, TX; and †Medical University of South Carolina, Charleston, SC.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Kusnezov
authors.forename: John C
authors.initials: JC
authors.lastname: Dunn
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: DeLong
authors.forename: Brian R
authors.initials: BR
authors.lastname: Waterman
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D011379:Prognosis; D012189:Retrospective Studies; D013247:Sternoclavicular Joint / Q000293:injuries* / Q000601:surgery*; D013710:Tendons / Q000637:transplantation; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology