Three-point suture anchor repair of traumatic sternoclavicular joint dislocation

Traumatic dislocation of the sternoclavicular joint (SCJ) is a rare injury. Previous techniques are associated with hardware migration, loss of reduction and infectious complications. We aim to describe our preferred surgical technique and summarize our experience with three-point suture technique of acute SCJ dislocation (SCJD). The objective of this study was to describe and assess the safety of three-point suture anchor repair technique in acute traumatic dislocation in the SCJ.

A 7-year retrospective study in a university affiliated level 1 trauma centre. Operative cases and the trauma registry was reviewed to identify all potential cases of SCJD between 2005 and 2011. Inclusion criteria for this study were computed tomography (CT) identification of Allman III SCJD, intra-operative confirmation of the CT findings, acute fixation defined as <7 days and surgical management with three-point suture anchor technique. Chronic cases, suspected SCJDs without CT confirmation, physeal injuries and other surgical techniques were excluded.

Eight patients met inclusion criteria. The patients were aged 16-46 years (mean age 24 years). Two primary surgeons were involved and time to surgery ranging from day of presentation to day 6 post injury. No loss to follow-up with clinical examinations and imaging being attended at 2 and 6 weeks, and 3 months. Average follow-up was 10.75 ± 5.30 months (3-18 months). All patients had uncomplicated post-operative course, with no evidence of respiratory compromise, swallowing difficulties during admission. In outpatient documentation there was no failure of hardware and no issues documented with regards to chronic pain or range of movement limitations secondary to pain. There have been no representations because of complications out to 6 years.

This series supports the safety of the three-point suture anchor technique in the acute stabilization of SCJD. The technique is demonstrated as a safe, effective and reproducible method of SCJ fixation.