A sternoclavicular dislocation is a specific type of joint injury that involves the dislocation of the joint between the sternum (breastbone) and the clavicle (collarbone). This injury occurs when the ligaments supporting the joint are stretched or torn, causing the bones to become misaligned. It is a relatively rare injury, accounting for approximately 3-5% of all shoulder girdle injuries. In this detailed article, we will explore the causes, symptoms, diagnosis, and treatment options for sternoclavicular dislocation.
Causes of Sternoclavicular Dislocation:
Sternoclavicular dislocations can occur due to various factors, including trauma, accidents, sports injuries, and certain medical conditions. The most common cause is a direct blow to the shoulder, such as during a fall, contact sports, or a sudden impact. These injuries are often associated with high energy or forceful impacts, making them more prevalent in athletes participating in contact sports like football, rugby, and wrestling.
Additionally, certain medical conditions, such as rheumatoid arthritis, can weaken the ligaments around the sternoclavicular joint, increasing the risk of dislocation. However, non-traumatic sternoclavicular dislocations are relatively rare compared to traumatic cases.
Symptoms of Sternoclavicular Dislocation:
Individuals with a sternoclavicular dislocation typically experience a range of symptoms that may vary in severity. These symptoms include:
1. Pain:
The most common symptom of a sternoclavicular dislocation is localized pain around the joint. The intensity of the pain can range from mild discomfort to severe, depending on the extent of the injury.
2. Swelling and Tenderness:
The joint may become swollen and tender to the touch due to the inflammation and damage to the surrounding tissues.
3. Visible Deformity:
In severe cases, a visible deformity or a bump may be noticeable on the affected side of the sternoclavicular joint. This deformity results from the misalignment of the bones.
4. Limited Range of Motion:
Individuals with a sternoclavicular dislocation may experience difficulty or pain while moving their arm, especially during overhead activities or when attempting to lift heavy objects.
Diagnosis of Sternoclavicular Dislocation:
To diagnose a sternoclavicular dislocation, a healthcare professional will conduct a thorough evaluation of the individual’s medical history, perform a physical examination, and order various diagnostic tests. These tests may include:
1. X-rays:
X-rays are commonly used to evaluate the position and alignment of the sternoclavicular joint. It helps identify any dislocation or fractures in the collarbone or breastbone.
2. CT Scan:
In some cases, a computed tomography (CT) scan may be recommended to obtain more detailed images of the joint and surrounding structures. This imaging study can help assess the extent of the injury and identify potential associated complications, such as vascular or nerve involvement.
3. MRI:
Magnetic resonance imaging (MRI) may be used in certain situations to evaluate the soft tissues, ligaments, and surrounding structures for any associated injuries or damage.
Treatment of Sternoclavicular Dislocation:
The most appropriate treatment for a sternoclavicular dislocation depends on various factors, including the severity of the injury, the age and overall health of the individual, and the presence of any associated complications. The main goals of treatment are to reduce pain, restore joint stability, and promote the return to normal function.
Here are some common treatment options for sternoclavicular dislocation:
1. Conservative Management:
Non-operative treatment is often recommended for individuals with stable sternoclavicular dislocations. This approach generally involves pain management, rest, and immobilization of the joint using a sling or brace. Physical therapy may also be included to strengthen the surrounding muscles and improve range of motion.
2. Closed Reduction:
In cases where the dislocation is not stable or cannot be managed conservatively, a procedure called closed reduction may be performed. During this procedure, a healthcare professional gently manipulates the bones back into their normal alignment. This may be done under either local or general anesthesia, depending on the individual’s comfort level and the complexity of the dislocation.
3. Surgical Intervention:
In rare instances where non-operative or closed reduction methods are unsuccessful or there are associated complications, surgical intervention may be necessary. Surgery typically involves stabilizing the joint using various techniques, such as ligament repair or reconstruction, plate and screw fixation, or joint fusion. The specific surgical approach will depend on the individual case and the surgeon’s expertise.
4. Rehabilitation:
Following any form of treatment, a comprehensive rehabilitation program is essential to ensure optimal recovery. Physical therapy is a critical component of rehabilitation and aims to restore strength, range of motion, and functional abilities of the shoulder joint. The program may include exercises for strengthening the surrounding muscles, stretching, joint mobilization, and functional activities tailored to the individual’s specific needs.