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SC DislocationAka: Sternoclavicular Dislocation, SC Separation, Sternoclavicular Separation

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  1. Epidemiology
    1. Uncommon injury
  2. Mechanism
    1. SC dislocation results from direct fall onto shoulder
  3. Types of Sternoclavicular dislocation
    1. Anterior Dislocation (More common)
      1. May occasionally occur spontaneously without trauma
        1. Older adult presents with painless sternal mass
        2. Affects sternal end of clavicle
    2. Posterior Dislocation
      1. Rarely may cause pressure anterior neck
        1. Leads to Dyspnea and vascular compression
        2. Requires emergent reduction
  4. Differential Diagnosis
    1. Epiphyseal Fracture in child
      1. Non-surgical management as with SC dislocation
  5. Symptoms and Signs
    1. Tender, visible prominence at sternoclavicular Joint
    2. Discomfort with Shoulder Range of Motion
  6. Radiology: Shoulder XRay
    1. SC Joint difficult to visualize on XRay
    2. View angled upward including uninjured side helpful
    3. Sternoclavicular joint MRI may be necessary
  7. Management: SC Anterior dislocation
    1. Reduction by traction and manipulation
      1. Reduction difficult to maintain
      2. Commonly recurs
      3. No loss of function (cosmetic only)
    2. Surgery (rarely indicated)
      1. Indicated for post-traumatic arthritis
      2. Excise medial 1 to 2 cm of clavicle

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