Sternoclavicular Joint Injuries: Sprains, Dislocations, and Rehabilitation

Introduction

The sternoclavicular joint is an essential structure of the upper limb. Clavicle and sternum forms sternoclavicular joint. This joint protects vital organs like the trachea and esophagus. The sternoclavicular joint can be injured due to accidents or trauma during sports which result in dislocation and sprain to the joint. Osteoarthritis can also cause disorders in SC joints. The most common difficulties of SC joints can be sprain and dislocation. These conditions commonly cause pain and discomfort to the patient. Severe injuries may cause life-threatening conditions. Therefore, immediate treatment of the injured sternoclavicular joint is essential. Depending upon the severity, conservative and surgical treatments are available in case of SC disorders.

What Are Sternoclavicular Joint Disorders?

Four joints form the shoulder, and the sternoclavicular joint is one. The clavicle ( collar bone) meets the sternum (breastbone) at the lower border of the neck and forms the sternoclavicular joint. Usually, it is uncommon, but injury, trauma, or some diseases can cause sternoclavicular joint disorders. The most common causes of sprain and dislocation in SC joints are car accidents or injuries during sports like football, kabaddi, and wrestling. These injuries are excruciating and cause discomfort. Injuries to SC joints have properties of self-healing. Sometimes internal organs below the sternum and clavicle did damage due to four School impacts of the injury. This condition comes under severe injury, and emergency treatment should be done. Protective covers and tissues surround the SC joint. The protective cover gets thinned over time and causes damage to the joint, which results in pain and restricted movement of hands and shoulders.

What Is the Anatomy of the Sternoclavicular Joint?

The clavicle (collar bone) and sternum (breastbone) form the sternoclavicular joint. The arm is connected to the shoulder with the sternoclavicular joint. Articular cartilage covers the SC joint and helps smooth gliding while moving arms and shoulders. The surrounding SC joint contains connective tissue and ligaments, which provide strength, stability, and protection. Below the SC joint important structures like nerves, blood vessels, trachea, and esophagus are present. Sternum provides protection to organs beneath.

What Are the Causes of Sternoclavicular Joint Disorders?

The most common causes of irregular drawing disorders are listed below -

• Car accidents, full-force trauma, or Injury during sports can cause sternoclavicular joint dislocation and sprain.

• Osteoarthritis can also cause sternoclavicular joint disorder.

What Are the Different Disorders of the Sternoclavicular Joint?

Disorders of the sternoclavicular joint are listed below -

1. The Disorder Caused by Injury - The sternoclavicular joint injuries can cause -

• Sprain.

• Ligament pull/muscle pull.

• Clavicle fracture.

• Dislocated Clavicle - It is a rare condition but can be seen in cases of injuries. Two types of dislocations are present.

• Anterior Dislocation of Clavicle - The clavicle is shifted in a forwarding position and seated before the sternum.

• Posterior Dislocation of Clavicle - The clavicle is shifted in a backward position and seated after the sternum, placed inside the upper chest.

These are serious injuries; both the dislocations need immediate treatment, but the posterior clavicle dislocation is more serious because it can damage the important structure that lies beneath the sternum. The damaged vital organs can result in life-threatening conditions.

2. Osteoarthritis - It is a degenerative condition commonly seen in older people (age more than 50 years). Cartilages present in the surrounding sternoclavicular joint get worn off with time. These cartilages provide support, stability, and protection to SC joints. Wearing off cartilage results in loss of stability and protection, which causes friction of bones and frequent dislocation of the SC joint. Friction between bones causes pain and discomfort; sometimes, little bony prominences emerge. Osteoarthritis is a slow process And can progress to pain and discomfort with time.

3. Other Disorders - Other disorders of the sternoclavicular joint include -

• Rheumatoid arthritis.

• Infection.

• Fracture.

• Subluxation.

What Are the Causes of Sternoclavicular Joint Injury?

The sternoclavicular joint is a well-protected space because it has a strong surrounding of cartilage. As a result, minor injuries cannot affect the joint. It takes high-impact injuries like a direct blow or high-impact accidents to dislocate or injure the sternoclavicular joint.

Some causes of injuries are listed below -

• Sprinting with other players during Sports.

• Bad landing or falling during contact Sports.

• Accidents with vehicles.

• Fights.

What Are the Symptoms of the Sternoclavicular Joint Disorder?

Disorder of the sternoclavicular joint ranges from mild to severe. The signs and symptoms are as follows -

• Presence of Inflammation, bruises, and tender joint.

• During the movement of the arm, friction sounds.

• Restricted mobility of the arm.

• Pain present over the sternoclavicular joint.

• Sharp shooting pain in case of the fractured clavicle.

• Redness and high temperature ( in case of infection).

How to Diagnose Sternoclavicular Joint Disorders?

For proper diagnosis of the sternoclavicular joint disorder, the medical professional will ask for medical and personal history. Then, the doctor will perform physical and digital examinations.

1. History - Medical and personal history are asked for information about previous injuries, accidents, or medical conditions. It also includes questions like, how the pain began and when the pain started.

2. Physical Examination - The doctor will go for a physicalexamination to check any visible symptoms like bruises, redness, temperature, arm movement, and any external injury in the area of SC joints.

3. Digital Examination - X- rays and CT (computed tomography) scans are helpful in the diagnosis of sternoclavicular joint disorder. X-rays of the chest, arm, and shoulder area will show any fracture segment. CT scan is very helpful in better evaluation of injury and helps in the differentiation of different disorders like sprain and dislocation.

What Are the Treatments for Sternoclavicular Joint Disorders?

Sternoclavicular joint disorders have self-healing properties; they get healed without any surgical intervention. Serious disorder of SC joints requires surgical treatment.

Non-Surgical Treatment - Conservative or non-surgical treatment includes -

• Medications - Nonsteroidal anti-inflammatory drugs (NSAIDs), like Naproxen and Ibuprofen, are helpful in reducing pain and inflammation of joints. Steroid injections are also helpful in the relief of pain and swelling. A doctor's prescription is necessary before taking any medication.

• Immobilization - Restricted arm movement is advisable in case of injuries to promote healing. A shoulder sling is helpful in the immobilization of the arm and shoulder.

• Physical Activity Modification - It is advisable for patients with osteoarthritis to avoid excessive physical activity.

• Closed Reduction - In case of clavicular dislocation, a Medical professional will try to place the clavicle back in its previous position without any surgical procedure. This procedure is done under general anesthesia.

• Surgical Treatment - Non-surgical procedures are mostly not helpful in the case of posterior clavicle dislocation. In this condition, the doctor will perform surgical treatment, which is known as open reduction. In this procedure, the clavicle is placed back in its previous position with the help of an incision under general anesthesia.

• Treatment for Infected SC Joint - If there is an infection present in the sternoclavicular joint immediate treatment is recommended, which includes opening the joint with a small cut and draining out the infection. A full course of antibiotics is also prescribed.

Conclusion

The sternoclavicular joint is present below the neck. It is formed by the sternum and clavicle bones. Disorder in the sternoclavicular joint can happen due to injury, accidents, or infection. Dislocation and sprains are the two most common types of disorders. These disorders cause pain and discomfort. Minor injuries of the sternoclavicular joint get healed by themselves, but severe cases need proper treatment and care. Treatment includes non-surgical treatment and surgical treatments.