Sternoclavicular dislocation as a possible complication for surgical Scheuermann’s deformity correction: a case report

Abstract

Objective

We present a sternoclavicular dislocation as a non-reported complication after spinal kyphotic deformity surgical correction.

Background

The sternocostal complex seems to have an important role in the pathology of Scheuermann’s kyphotic deformity. A role for the sternoclavicular complex has never been reported in association with Scheuermann’s disease pathology but could explain anterior sternoclavicular dislocation after spinal kyphotic deformity correction.

Methods

A 19-year-old male patient underwent surgery for a 74° thoracic kyphosis associated with a 35° thoracic and a 50° lumbar scoliotic curve. In the early post-operative period, the patient developed pain over the left sternoclavicular joint articulation, with a very obvious lump. An X-ray disclosed an anterior sternoclavicular dislocation. After surgical treatment failed, the dislocation was repaired in a second surgical procedure with a flexion and lengthening osteotomy of the middle third of the clavicle followed by capsular repair reinforced with sternocleidomastoid fascia.

Results

At an 8-year follow-up after his spine procedure and 6 years after his clavicular surgery, the patient had full shoulder range of motion and no joint pain, despite the presence of a new sternoclavicular anterior dislocation.

Conclusion

Sternoclavicular dislocation after spine kyphotic deformity correction is presented for the first time; however, it is not possible to establish a causative association. Additional studies are necessary to delineate the role of the sternoclavicular complex in Scheuermann’s disease.

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Acknowledgements

The authors wish to thank Merry Diana Johannes (independent editor) for her assistance in preparing and revising the manuscript.

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Correspondence to Joaquim Soares do Brito.

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do Brito, J.S., Martins, S. & Fernandes, P. Sternoclavicular dislocation as a possible complication for surgical Scheuermann’s deformity correction: a case report. Eur Spine J 29, 133–137 (2020). https://doi.org/10.1007/s00586-019-06132-9

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Keywords

  • Scheuermann’s kyphosis
  • Pathogenesis
  • Sternocostal complex
  • Sternoclavicular dislocation
  • Sternoclavicular complex