Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Separation of the Sternoclavicular Joint

The sternoclavicular joint is seldom separated, but it is an important injury to recognize. The medial end of the clavicle, and hence the shoulder, is anchored to the sternum by the sternoclavicular ligaments. The joint cavity lies obliquely and contains a meniscus (disk). If the shoulder is subjected to a violent impact, the sternoclavicular joint can slip and the ligaments can tear, causing the medial end of the clavicle to move either in an anterior direction making it more prominent, or posterior.

Symptoms and diagnosis

– Pain may be located towards the shoulder region rather than in the sternoclavicular joint itself.
– Tenderness occurs when pressure is applied to the joint.
– The clavicle is usually only partially separated, but its medial end can be completely detached from the sternum.

Treatment

The doctor may:
– in cases of partial separation, suggest that the injured person rest for 1–2 weeks with mobilization of the shoulder as tolerated;
– in cases of posterior separation, make sure that there is no pressure or damage to the underlying vessels. Surgery is indicated in cases of complete posterior dislocation;
– An X-ray and CT scan should be obtained.
– If the clavicle is displaced backwards (posteriorly) towards the major blood vessels, life-threatening injury can occur.
– operate in cases with chronic pain or major discomfort. The surgery usually involves excision of the medial end of the clavicle bone.

Healing

In cases of partial separation of the sternoclavicular joint, the injured athlete can generally resume sporting activity early; however, pain and other symptoms may remain for several months.

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