[Traumatic Posterior Sternoclavicular Joint Dislocation in Adolescents]

Posterior sternoclavicular joint (SCJ) dislocation is a rare injury, usually caused by a direct blow to the medial chest wall. The SCJ is inherently unstable due to its bony components and most of its stability is derived from surrounding soft tissue. Among skeletally immature patients it is important to differentiate between true SCJ dislocation and fractures through the medial clavicle growth plate. There is a high anatomical proximity between the SCJ and mediastinal retrosternal structures, as the thoracic blood vessels, and traumatic posterior SCJ dislocation has the potential of harming these anatomical structures and creating significant symptoms and even life-threatening symptoms during injury or during treatment. Diagnosis of posterior SCJ dislocation can be challenging and necessitates focused physical examination and radiological work-up including X-rays and a CT scan. Treatment posterior SCJ dislocations includes prompt reduction of the joint, mostly open reduction of the joint and stabilization with internal fixation. Due to the risk of damage to the blood vessels in the chest, a thoracic surgeon should be involved in the surgical procedure. Open reduction and internal fixation of this injury is a safe and efficient treatment, with a low complication rate, that allows fast and full recovery of the injured limb and avoids long term symptoms and complications.