Description
Introduction
Dislocation of the sternoclavicular joint (SCJ) is a rare injury. It affects only 3% of shoulder girdle injuries and only a few part of these (5-27%) are posterior. A crucial point of SCJ posterior dislocations is the presence in the posterior mediastic space of noble structures that can transform the treatment into an emergency if injured. Various surgical techniques for SCJ reduction and stabilization have been described. In this study we analyzed the clinical and functional outcomes (including the return to sport) of elite athletes surgically treated for a posterior sternal clavicle dislocation
Methods
A retrospective analysis was conducted including all elite sport patients acceding directly to our hospital diagnosed of acute posterior SCJ dislocations from 2018 to 2022.
Exclusion criteria were: anatomical deformity, chronic dislocation, age lower than 18, clavicula or sternum fractures, poor general condition, atraumatic dislocation, posterior subluxation, previous any clavicular surgery, conservative treatment.
We use a modified figure-8-technique reconstruction with autograft plus an anchor.
Post-operative follow-up included a clinical and radiographic evaluation at 1-3-6-12 months after surgery. The function was evaluated, at the end of the follow-up with Disability of the Arm, Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), Constant, Nottingham Clavicle Score, VAS e Tegner Activity Scale.
Results
At 6 months after surgery, the patients had a complete range of motion of the upper limb. The questionnaires presented an average score of 0 (excellent) for DASH, 48 for OSS, 0 for VAS and excellent for Constant and Nottingham. The patients returned to their previous sports activities with an average Tegner of 8. There were no short- or medium-term complications (at the last follow-up visit).
Conclusion
The figure-of-8 reconstruction technique with a semitendinosus graft plus an anchor is a reliable and efficient procedure that guarantee a quick return-to-play and good stability in high activity patients such as elite sport players.
