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The Sternoclavicular Joint

  • Chapter
Physical Examination of the Shoulder

Abstract

Acute injuries to the sternoclavicular (SC) joint typically occur as a result of high-energy trauma and, in some cases, may compromise vital mediastinal structures. While acute injuries are relatively uncommon, chronic symptomatology has become a widely recognized source of shoulder pain and dysfunction. The purpose of this chapter is to review the relevant anatomy, biomechanics, and physical examination of the SC joint using an evidence-based approach.

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References

  1. Koch MJ, Wells L. Proximal clavicle physeal fracture with posterior displacement: diagnosis, treatment, and prevention. Orthopedics. 2012;35(1):e108–11.

    PubMed  Google Scholar 

  2. Webb PA, Schuey JM. Epiphyseal union of the anterior iliac crest and medial clavicle in a modern multiracial sample of American males and females. Am J Phys Anthropol. 1985;68(4):457–66.

    Article  CAS  PubMed  Google Scholar 

  3. Martetschläger F, Warth RJ, Millett PJ. Instability and degenerative arthritis of the sternoclavicular joint: a current concepts review. Am J Sports Med. 2014;42(4):999–1007.

    Article  PubMed  Google Scholar 

  4. Hobbs DW. Sternoclavicular joint: a new axial radiographic view. Radiology. 1968;90:801.

    Article  CAS  PubMed  Google Scholar 

  5. Lowman CL. Operative correction of old sternoclavicular dislocation. J Bone Joint Surg. 1928;10:740–1.

    Google Scholar 

  6. Ponce BA, Kundukulam JA, Pflugner R, McGwin G, Meyer R, Carroll W, Minnich DJ, Larrison MC. Sternoclavicular joint surgery: how far does danger lurk below? J Shoulder Elbow Surg. 2013;22(7):993–9.

    Article  PubMed  Google Scholar 

  7. Tuscano D, Banerjee S, Terk MR. Variations in normal sternoclavicular joints; a retrospective study to quantify SCJ asymmetry. Skeletal Radiol. 2009;38(10):997–1001.

    Article  PubMed  Google Scholar 

  8. Wijertna MD, Turmezei TD, Tytherleigh-Strong G. Novel assessment of the sternoclavicular joint with computed tomography for planning interventional approach. Skeletal Radiol. 2013;42(4):473–8.

    Article  Google Scholar 

  9. DePalma AF. Surgical anatomy of the acromioclavicular and sternoclavicular joints. Surg Clin North Am. 1963;43:1541–50.

    CAS  PubMed  Google Scholar 

  10. van Tongel A, van Hoof T, Pouliart N, Debeer P, D’Herde K, De Wilde L. Arthroscopy of the sternoclavicular joint: an anatomic evaluation of structures at risk. Surg Radiol Anat. 2014;36(4):375–81.

    PubMed  Google Scholar 

  11. Lee JT, Campbell K, Michalski M, Wilson K, Spiegl U, Wijdicks C, Millett PJ. Surgical anatomy of the sternoclavicular joint: a qualitative and quantitative anatomical study. J Bone Joint Surg. 2014;96(19):e166.

    Google Scholar 

  12. Bearn JG. Direct observations on the function of the capsule of the sternoclavicular joint in the clavicular support. J Anat. 1967;101(Pt 1):159–70.

    CAS  PubMed Central  PubMed  Google Scholar 

  13. Spencer EE, Kuhn JE, Huston LJ, Carpenter JE, Hughes RE. Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. J Shoulder Elbow Surg. 2002;11(1):43–7.

    Article  PubMed  Google Scholar 

  14. Cave AJ. The nature and morphology of the costoclavicular ligament. J Anat. 1961;95:170–9.

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Tubbs RS, Shah NA, Sullivan BP, Marchase ND, Cömert A, Acar HI, Tekdemir I, Loukas M, Shoja MM. The costoclavicular ligament revisited: a functional and anatomic study. Rom J Morphol Embryol. 2009;50(3):475–9.

    PubMed  Google Scholar 

  16. Brossman J, Stäbler A, Preidler K, Trudell D, Resnick D. Sternoclavicular joint: MR imaging–anatomic correlation. Radiology. 1996;198(1):193–8.

    Article  Google Scholar 

  17. Emura K, Arakawa T, Terashima T, Miki A. Macroscopic and histological observations on the human sternoclavicular joint disc. Anat Sci Int. 2009;84(3):182–8.

    Article  PubMed  Google Scholar 

  18. Barbaix E, Lapierre M, Van Roy P, Clarijs JP. The sternoclavicular joint: variants of the discus articularis. Clin Biomech (Bristol, Avon). 2000;15 Suppl 1:S3–7.

    Article  Google Scholar 

  19. Renfree KJ, Wright KW. Anatomy and biomechanics of the acromioclavicular and sternoclavicular joints. Clin Sports Med. 2003;22:219–37.

    Article  PubMed  Google Scholar 

  20. Inman VT, Saunders DM, Abbott LC. Observations on the function of the shoulder joint. J Bone Joint Surg. 1944;26:1–30.

    Google Scholar 

  21. Rockwood CA, Williams GR, Young DC. Disorders of the acromioclavicular joint. In: Rockwood Jr CA, Mattson FA, editors. The shoulder. 2nd ed. Philadelphia: WB Saunders; 1998.

    Google Scholar 

  22. Elhassan B, Chung ST, Ozbaydar M, Diller D, Warner JJ. Scapulothoracic fusion for clavicular insufficiency. A report of two cases. J Bone Joint Surg Am. 2008;90(4):875–80.

    Article  PubMed  Google Scholar 

  23. Groh GI, Wirth MA. Management of traumatic sternoclavicular joint injuries. J Am Acad Orthop Surg. 2011;19(1):1–7.

    PubMed  Google Scholar 

  24. Panzica M, Zeichen J, Hankemeier S, Gaulke R, Krettek C, Jagodzinski M. Long-term outcome after joint reconstruction or medial resection arthroplasty for anterior SCJ instability. Arch Orthop Trauma Surg. 2010;130(5):657–65.

    Article  PubMed  Google Scholar 

  25. de Jong KP, Sukul DM. Anterior sternoclavicular dislocation: a long term follow-up study. J Orthop Trauma. 1990;4(4):420–3.

    Article  PubMed  Google Scholar 

  26. Wirth MA, Rockwood CA. Disorders of the sternoclavicular joint. In: Rockwood Jr CA, Matsen III FA, Wirth MA, Lippitt SB, editors. The shoulder. 4th ed. Philadelphia: Saunders; 2009. p. 527–60.

    Google Scholar 

  27. Chaudhry FA, Killampalli VV, Chowdhry M, Holland P, Knebel RW. Posterior dislocation of the sternoclavicular joint in a young rugby player. Acta Orthop Traumatol Turc. 2011;45(5):376–8.

    PubMed  Google Scholar 

  28. Perron AD. Chest pain in athletes. Clin Sports Med. 2003;22:37–50.

    Article  PubMed  Google Scholar 

  29. Allman Jr FL. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am. 1967;49(4):774–84.

    PubMed  Google Scholar 

  30. Iannotti JP, Williams GR. Disorders of the shoulder: diagnosis and management. Philadelphia: Lippincott Williams & Wilkins; 1999. p. 765–813.

    Google Scholar 

  31. El Mekkaoui MJ, Sekkach N, Bazeli A, Faustin JM. Proximal clavicle physeal fracture-separation mimicking an anterior sterno-clavicular dislocation. Orthop Traumatol Surg Res. 2011;97(3):349–52.

    Article  PubMed  Google Scholar 

  32. Eni-Olotu DO, Hobbs NJ. Floating clavicle – simultaneous dislocation of both ends of the clavicle. Injury. 1997;28(4):319–20.

    Article  CAS  PubMed  Google Scholar 

  33. Sanders JO, Lyons FA, Rockwood Jr CA. Management of dislocations of both ends of the clavicle. J Bone Joint Surg Am. 1990;72(3):399–402.

    CAS  PubMed  Google Scholar 

  34. Thomas Jr CB, Friedman RJ. Ipsilateral sternoclavicular dislocation and clavicle fracture. J Orthop Trauma. 1989;3(4):355–7.

    Article  PubMed  Google Scholar 

  35. Lunseth PA, Chapman KW, Frankel VH. Surgical treatment of chronic dislocations of the sterno-clavicular joint. J Bone Joint Surg Br. 1975;57(2):193–6.

    CAS  PubMed  Google Scholar 

  36. Yeh GL, Williams Jr GR. Conservative management of sternoclavicular injuries. Orthop Clin North Am. 2000;31(2):189–203.

    Article  CAS  PubMed  Google Scholar 

  37. Bicos J, Nocholson GP. Treatment and results of sternoclavicular joint injuries. Clin Sports Med. 2003;22(2):359–70.

    Article  PubMed  Google Scholar 

  38. Eskola A, Vainionpaa S, Vastamaki M, Slatis P, Rokkanen P. Operation for old sternoclavicular dislocation: results in 12 cases. J Bone Joint Surg Br. 1989;71(1):63–5.

    CAS  PubMed  Google Scholar 

  39. Rockwood CA, Groh GI, Wirth MA, Grassi FA. Resection arthroplasty of the sternoclavicular joint. J Bone Joint Surg Am. 1997;79(3):387–93.

    PubMed  Google Scholar 

  40. Warth RJ, Lee JT, Campbell KJ, Millett PJ. Arthroscopic sternoclavicular joint resection arthroplasty: a technical note and illustrated case report. Arthrosc Tech. 2014;3(1):e165–73.

    Article  PubMed Central  PubMed  Google Scholar 

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Warth, R.J., Millett, P.J. (2015). The Sternoclavicular Joint. In: Physical Examination of the Shoulder. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2593-3_8

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  • DOI: https://doi.org/10.1007/978-1-4939-2593-3_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2592-6

  • Online ISBN: 978-1-4939-2593-3

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