The Shoulder

Shoulder Girdle

Traumatic dislocation of the sterno-clavicular joint

Symptoms and signs

Sternoclavicular dislocations are rare.

The anterior dislocation is the commonest; the ratio of anterior dislocations to posterior dislocations is approximatively 20 to 1.

Symptoms resemble very well those of a proximal fracture of the clavicle:

The patient usually supports the injured arm across the trunk with the normal arm
the affected shoulder girdle appears to be shortened and the head is tilted to the side of the dislocated joint.
All movements (active and passive) of the shoulder girdle increase the pain.

In case of an anterior subluxation the medial end of the clavicle is visibly prominent to the sternum and can be palpated anterior to the sternum.

A patient with a posterior subluxation has usually more pain than a patient with anterior dislocation; venous congestion may be present in the neck and/or in the upper extremity; the patient may also complain of difficulty in swallowing or breathing.

Treatment

Most cases of (anterior) subluxation are reduced by drawing the shoulders backwards. A clavicle strap or a figure 8 bandage should be used to protect from further dislocation for four to six weeks.
In severe dislocations, operative treatment will be necessary.

Preliminary Examination / Interpretation / Pathology of Shoulder Girdle / Sternoclavicular Lesions