Surgical treatment of anterior sternoclavicular dislocation associated with midshaft clavicle fracture: A case report

Abstract

A combination of an anterior sternoclavicular (SC) joint dislocationwith a midshaft clavicle fracture is an extremely rare injury. If leftuntreated, it can lead to severely impaired function of the shoulderwith a high risk for complications. A 45-year-old male patientpresented with pain and impaired range of motion (ROM) inthe left shoulder after a mountain bike crash. Radiographs and acomputed tomography scan showed an anterior dislocation of theleft SC joint and an ipsilateral midshaft fracture of the clavicle.Open reduction and internal fixation (ORIF) of the claviclecombined with SC joint stabilization using transosseous sutureswas performed. Postoperatively, a shoulder-arm bandage wasapplied with passive motion starting on the first postoperative day.During follow-up, the patient showed an improved clinical functionand could return to work after three weeks. Radiographs at eightweeks showed fracture healing without any signs of recurrent SCdislocation. At the final follow-up at 12 weeks, the patient returnedto his pre-injury activity level and recreational sports. Despiteminimal redislocation in the SC joint, the Constant-Murley Scoreshowed a continuous improvement with 93%, compared to thecontralateral side. In conclusion, surgical treatment of anteriorSC joint dislocation with a midshaft clavicle fracture can restoreshoulder function with no surgery-associated complications.