Posterior sternoclavicular Salter-Harris fracture-dislocation in a patient with unossified medial clavicle epiphysis
- 23 April 2016
- journal article
- case report
- Published by Springer Science and Business Media LLC in Skeletal Radiology
- Vol. 45 (8), 1123-1127
- https://doi.org/10.1007/s00256-016-2399-2
Abstract
Sternoclavicular injuries are relatively rare, composing less than 1 % of all musculoskeletal fractures or dislocations. When sternoclavicular injuries do occur, they typically present as an isolated dislocation of the sternoclavicular joint without associated fracture of the clavicle or manubrium. However, in patients with unfused medial clavicle physis, sternoclavicular joint injuries can present as a fracture-dislocation through the unfused physis. These physeal injuries are important to recognize as the displaced epiphysis can block reduction of the sternoclavicular joint. We present a case of a 15-year-old female basketball player presenting with suspected sternoclavicular joint injury after sustaining a direct blow to the left shoulder. An initial shoulder CT confirmed the presence of the clinically suspected posterior sternoclavicular dislocation without fracture identified. An MRI of the left sternoclavicular joint was then performed for suspected physeal fracture, which confirmed the presence of a fracture through the medial clavicle physis with anterior displacement of the unossified epiphysis, blocking reduction of the metaphysis. Given the findings on MRI, the pediatric orthropedic surgeon was able to counsel the family of the high likelihood of failed closed reduction of the sternoclavicular joint requiring conversion to open reduction and internal fixation. The patient underwent successful open reduction and internal fixation of the medial clavical physeal fracture after an initial gentle attempt at closed reduction was unsuccessful.Keywords
This publication has 14 references indexed in Scilit:
- Management and functional outcomes following sternoclavicular joint dislocationInjury, 2015
- Posterior Sternoclavicular Joint Injuries in Skeletally Immature PatientsJournal of Pediatric Orthopaedics, 2014
- Posterior Sternoclavicular Joint Injuries in the Adolescent PopulationThe American Journal of Sports Medicine, 2014
- Treatment of Sternoclavicular Joint Dislocations: A Systematic Review of 251 Dislocations in 24 Case SeriesJournal Of Trauma-Injury Infection and Critical Care, 2011
- Posterior Dislocation of the Sternoclavicular Joint with Obstruction of the Innominate VeinThe Journal of Trauma and Acute Care Surgery, 1998
- Distribution of Physeal and Nonphyseal Fractures in 2,650 Long-Bone Fractures in Children Aged 0–16 YearsJournal of Pediatric Orthopaedics, 1990
- Epiphyseal union of the anterior iliac crest and medial clavicle in a modern multiracial sample of American males and femalesAmerican Journal of Physical Anthropology, 1985
- Skeletal Growth Mechanism Injury PatternsJournal of Pediatric Orthopaedics, 1982
- Retrosternal dislocation of the clavicleInjury, 1973
- STERNOCLAVICULAR DISLOCATIONSThe Journal of Trauma and Acute Care Surgery, 1968