The Journal of Bone and Joint Surgery, Vol 71, Issue 9 1280-1288, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Spontaneous atraumatic anterior subluxation of the sternoclavicular joint
CA Rockwood and JM Odor
University of Texas Health Science Center, School of Medicine, San Antonio 78284-7774.
We reviewed the cases of thirty-seven young patients, ten to thirty-six
years old, who had had spontaneous atraumatic anterior subluxation of the
sternoclavicular joint. Sudden atraumatic subluxation is quite alarming to
the patient and the physician. Twenty-nine of the thirty-seven patients
were treated non-operatively by observation and rehabilitative measures.
Eight patients had been treated elsewhere with attempted operative
reconstruction of the sternoclavicular joint or with resection
arthroplasty. After an average follow-up of eight years, the twenty-nine
patients who were treated non-operatively (group I) had excellent results,
with no limitations of activity or changes in life-style. The eight
patients who were treated operatively (group II) had numerous problems,
including noticeable scars, persistent instability, pain, or limitation of
activity that resulted in an alteration in lifestyle. Three of the eight
patients had had a resection of the medial portion of the clavicle. Two of
them had a second resection and the third patient had a third resection. A
thoracic-outlet syndrome developed in this patient and the clavicle had to
be totally resected to obtain relief. Since spontaneous atraumatic anterior
subluxation of the sternoclavicular joint has a benign natural course, it
should not be treated with operative stabilization of the joint. Instead, a
conservative approach that includes education and reassurance of the
patient will result in an unaltered lifestyle with no limitation of
activity and little or no discomfort.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
