Sternoclavicular dislocation: Difference between revisions
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**Consider IV contrast if concern for injury to mediastinal structures | **Consider IV contrast if concern for injury to mediastinal structures | ||
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===Sprain=== | ===Sprain=== | ||
*Rice, sling, analgesics | *Rice, sling, analgesics | ||
Revision as of 23:30, 9 February 2012
Background
- Very stable joint; majority of injuries are simple sprains
- Dislocations usually require severe force (MVC, sports injuries)
- Anterior dislocations are much more common than posterior
Clinical Features
Sprain
- Pain and swelling are localized to the joint
Dislocation
- Severe pain that is exacerbated by arm motion and lying supine
- Shoulder appears shortened and rolled forward
- Anterior dislocation: prominent medial clavicle end is visible/palpable ant to sternum
- Posterior dislocation: Medial end is less visible and often not palpable
Diagnosis
- CT
- Study of choice (plain films may not be diagnostic)
- Consider IV contrast if concern for injury to mediastinal structures
Management
Sprain
- Rice, sling, analgesics
Anterior Dislocation
- May d/c without attempted reduction (no impact on function)
- Clavicular splinting, ice, analgesics
- Ortho referral
Posterior Dislocation
- May be assoc w/ life-threatening injuries:
- PTX, compression/laceration of surrounding great vessels, trachea, or esophagus
- Consult ortho for closed reduction (ideally performed in the OR)
Source
- Tintinalli