Advances in the Management of Sternoclavicular Joint Injuries

➢ The sternoclavicular joint (SCJ) serves as the only osseous connection between the axial skeleton and the upper limb and is a synovial, saddle-like joint with robust posterior ligamentous stabilizers and a fibrocartilaginous disc. ➢ The brachiocephalic veins and other mediastinal structures are at risk from injury or surgery about the SCJ. ➢ SCJ injuries are best imaged with computed tomography (CT). CT angiography is warranted when a vascular injury is suspected, and magnetic resonance imaging (MRI) is useful to define soft-tissue injuries. ➢ Acute posterior SCJ dislocations in active, healthy individuals can result in considerable disability if unreduced and an aggressive treatment approach is warranted. ➢ Chronic locked posterior dislocations are more challenging to treat, making prompt recognition and referral (if appropriate) important. ➢ Reliable surgical techniques including ligament reconstruction and open reduction and internal fixation for SCJ injuries have been well supported in the current orthopaedic literature. ➢ Vascular injury is a rare but catastrophic concern when dealing with SCJ pathology and should be considered when determining the venue for planned intervention, as should collaboration with a thoracic or vascular surgeon.