Posterior Sternoclavicular Joint Reconstruction With Semitendinosus Allograft for Symptomatic Posterior...

Posterior sternoclavicular joint (SCJ) dislocations are uncommon because of the strength of the posterior joint capsule but pose a significant risk of neurovascular and mediastinal compression. Various surgical techniques have been described, with the sternal docking reconstruction using tendon allografts demonstrating improved biomechanical stability, elimination of anterior bulk, and ease of graft passage. This study outlines the intramedullary posterior SCJ reconstruction with a semitendinosus allograft for recurrent symptomatic posterior SCJ dislocations.

Surgical reconstruction is indicated in patients with symptomatic recurrent posterior SCJ dislocations that fail conservative management. A semitendinosus allograft with suture augmentation may be utilized because of its strength, availability, and ability to provide long-term stability while minimizing donor site morbidity.

The procedure involves an open reconstruction using a semitendinosus allograft, which is passed through bone tunnels in the clavicle and sternum to recreate the function of the sternoclavicular ligament. The graft is tensioned manually and secured using a nonabsorbable, high-tensile suture to restore joint stability while allowing for controlled mobility. The construct aims to replicate native joint biomechanics and reduce the risk of recurrent dislocations.

At 2 weeks postoperatively, the patient reports satisfactory recovery with improved shoulder stability and pain managed with over-the-counter analgesics. He has not experienced complications, such as infection, neurovascular impairment, or graft failure. Continued rehabilitation is expected to facilitate return to full function.

This study presents the surgical management of a recurrent posterior SCJ dislocation in an 18-year-old male patient with a semitendinosus allograft reconstruction. Given the rarity of symptomatic posterior SCJ instability, the optimal surgical approach remains debated. Further research is warranted to establish best practices and long-term outcomes in SCJ reconstruction; however, numerous beneficial outcomes are reported for this reconstruction technique.

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.