Sternoclavicular Dislocations

EpidemiologySCJ Anterior DIslocation


Extremely uncommon

Stability provided by joint capsule /costoclavicular & interclavicular ligaments 


Recurrent instability uncommon


Many apparent dislocations in adolescents may be growth plate injuries 

-will remodel without treatment


If OA from chronic dislocation may resect SCJ




Anterior & posterior 



- more serious injury

- least common



- difficult on physical examination

- radiographs often are non diagnostic

- most consistent diagnostic modality = CT




SCJ CT Anterior DislocationSternoclavicular Anterior Dislocation


Usually managed non-operatively

- with activity modification and reassurance



- often will redislocate


Open reduction

- need to stabilise

- can use strip PL to stabilise

- uncertain if any benefit 




CT Posterior SCJ DislocationPosterior SCJ Dislocation CT


May require treatment because of proximity of major neurovascular structures and airway 


1.  Closed reduction

- performed under GA in operating room 

- chest surgeon available

- potential vascular / airway catastrophe associated with injuries to the mediastinum

- thorough vascular exam pre-operatively


2.  Assess stability


Successful closed reduction usually stable

- avoid internal fixation because of likelihood of hardware migration

- possible injury to the mediastinal structures


Closed reduction unsuccessful

- open reduction is indicated

- can stabilize with PL graft / intra-osseous sutures


SCJ Open ReductionSCJ Reduction 2SCJ Suture Fixation