Management and functional outcomes following sternoclavicular joint dislocation
Abstract Introduction The aim of this study is to describe the demographics, management and functional outcomes of patients presenting with a sternoclavicular joint (SCJ) dislocation. Methods A retrospective medical record review was conducted examining patients with SCJ dislocation admitted to an a...
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Veröffentlicht in: | Injury 2015-10, Vol.46 (10), p.1906-1913 |
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description | Abstract Introduction The aim of this study is to describe the demographics, management and functional outcomes of patients presenting with a sternoclavicular joint (SCJ) dislocation. Methods A retrospective medical record review was conducted examining patients with SCJ dislocation admitted to an adult level 1 trauma centre between 2004 and 2012. Patient demographics, symptoms, associated injuries, imaging technique used in diagnosis, surgical data and neurovascular complications were recorded. Patients received a single-page questionnaire to assess physical function using two validated shoulder questionnaires. Results A total of 22 patients were identified, out of which 77% sustained a posterior dislocation. Mean age was 30 years (range 16–65), and the most common cause of injury was a direct blow during sport ( n = 11). Open reduction and internal fixation were performed in 13 patients, definitive closed reduction used in seven and two patients were managed expectantly. Functional outcomes for patients were excellent, with American Shoulder and Elbow Society (ASES) and Subjective Shoulder Value (SSV) scores >80 in 87.5% of cases. There were preoperative symptoms consistent with mediastinal compression in 50% and one delayed presentation with thoracic outlet syndrome. No patient had neurovascular compromise or functional deficit post-operatively, regardless of joint congruency. Conclusion This is the largest case series from a single institution currently available examining SCJ dislocation. We recommend an initial trial of closed reduction, followed by open reduction and internal fixation if there is joint instability or malreduction. Functional outcome following both closed and open reduction of the SCJ is excellent. |
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Methods A retrospective medical record review was conducted examining patients with SCJ dislocation admitted to an adult level 1 trauma centre between 2004 and 2012. Patient demographics, symptoms, associated injuries, imaging technique used in diagnosis, surgical data and neurovascular complications were recorded. Patients received a single-page questionnaire to assess physical function using two validated shoulder questionnaires. Results A total of 22 patients were identified, out of which 77% sustained a posterior dislocation. Mean age was 30 years (range 16–65), and the most common cause of injury was a direct blow during sport ( n = 11). Open reduction and internal fixation were performed in 13 patients, definitive closed reduction used in seven and two patients were managed expectantly. Functional outcomes for patients were excellent, with American Shoulder and Elbow Society (ASES) and Subjective Shoulder Value (SSV) scores >80 in 87.5% of cases. There were preoperative symptoms consistent with mediastinal compression in 50% and one delayed presentation with thoracic outlet syndrome. No patient had neurovascular compromise or functional deficit post-operatively, regardless of joint congruency. Conclusion This is the largest case series from a single institution currently available examining SCJ dislocation. We recommend an initial trial of closed reduction, followed by open reduction and internal fixation if there is joint instability or malreduction. Functional outcome following both closed and open reduction of the SCJ is excellent.</description><identifier>ISSN: 0020-1383</identifier><identifier>EISSN: 1879-0267</identifier><identifier>DOI: 10.1016/j.injury.2015.05.050</identifier><identifier>PMID: 26169233</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Australia - epidemiology ; Closed reduction ; Female ; Fracture Fixation, Internal - methods ; Functional outcomes ; Humans ; Immobilization - methods ; Joint Dislocations - diagnosis ; Joint Dislocations - physiopathology ; Joint Dislocations - therapy ; Joint Instability - diagnosis ; Joint Instability - physiopathology ; Joint Instability - therapy ; Male ; Management ; Manipulation, Orthopedic - methods ; Middle Aged ; Neurovascular complications ; Open reduction ; Orthopedics ; Retrospective Studies ; Sternoclavicular Joint - injuries ; Sternoclavicular Joint - pathology ; Sternoclavicular Joint - physiopathology ; Sternoclavicular joint dislocation ; Trauma Centers - statistics & numerical data ; Treatment Outcome</subject><ispartof>Injury, 2015-10, Vol.46 (10), p.1906-1913</ispartof><rights>Elsevier Ltd</rights><rights>2015 Elsevier Ltd</rights><rights>Copyright © 2015 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c487t-5de443609312b14346fccbedaa254d7f34ded92f0869d6954ee0f9d9b5b29dc43</citedby><cites>FETCH-LOGICAL-c487t-5de443609312b14346fccbedaa254d7f34ded92f0869d6954ee0f9d9b5b29dc43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.injury.2015.05.050$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26169233$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kirby, J.C</creatorcontrib><creatorcontrib>Edwards, E</creatorcontrib><creatorcontrib>Kamali Moaveni, A</creatorcontrib><title>Management and functional outcomes following sternoclavicular joint dislocation</title><title>Injury</title><addtitle>Injury</addtitle><description>Abstract Introduction The aim of this study is to describe the demographics, management and functional outcomes of patients presenting with a sternoclavicular joint (SCJ) dislocation. Methods A retrospective medical record review was conducted examining patients with SCJ dislocation admitted to an adult level 1 trauma centre between 2004 and 2012. Patient demographics, symptoms, associated injuries, imaging technique used in diagnosis, surgical data and neurovascular complications were recorded. Patients received a single-page questionnaire to assess physical function using two validated shoulder questionnaires. Results A total of 22 patients were identified, out of which 77% sustained a posterior dislocation. Mean age was 30 years (range 16–65), and the most common cause of injury was a direct blow during sport ( n = 11). Open reduction and internal fixation were performed in 13 patients, definitive closed reduction used in seven and two patients were managed expectantly. Functional outcomes for patients were excellent, with American Shoulder and Elbow Society (ASES) and Subjective Shoulder Value (SSV) scores >80 in 87.5% of cases. There were preoperative symptoms consistent with mediastinal compression in 50% and one delayed presentation with thoracic outlet syndrome. No patient had neurovascular compromise or functional deficit post-operatively, regardless of joint congruency. Conclusion This is the largest case series from a single institution currently available examining SCJ dislocation. We recommend an initial trial of closed reduction, followed by open reduction and internal fixation if there is joint instability or malreduction. Functional outcome following both closed and open reduction of the SCJ is excellent.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Australia - epidemiology</subject><subject>Closed reduction</subject><subject>Female</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Functional outcomes</subject><subject>Humans</subject><subject>Immobilization - methods</subject><subject>Joint Dislocations - diagnosis</subject><subject>Joint Dislocations - physiopathology</subject><subject>Joint Dislocations - therapy</subject><subject>Joint Instability - diagnosis</subject><subject>Joint Instability - physiopathology</subject><subject>Joint Instability - therapy</subject><subject>Male</subject><subject>Management</subject><subject>Manipulation, Orthopedic - methods</subject><subject>Middle Aged</subject><subject>Neurovascular complications</subject><subject>Open reduction</subject><subject>Orthopedics</subject><subject>Retrospective Studies</subject><subject>Sternoclavicular Joint - injuries</subject><subject>Sternoclavicular Joint - pathology</subject><subject>Sternoclavicular Joint - physiopathology</subject><subject>Sternoclavicular joint dislocation</subject><subject>Trauma Centers - statistics & numerical data</subject><subject>Treatment Outcome</subject><issn>0020-1383</issn><issn>1879-0267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUU1LHTEUDaWlPrX_oMgsu5nnzcd8ZFMoYqtgcaGuQya5IxkziSYzyvv3zvC0i26EA3dzPrjnEPKdwpYCrU-HrQvDnHZbBrTawgr4RDa0bWQJrG4-kw0Ag5Lylh-Qw5wHANoA51_JAatpLRnnG3L9Vwd9jyOGqdDBFv0czORi0L6I82TiiLnoo_fxxYX7Ik-YQjRePzsze52KIbpFaF320ehVd0y-9Npn_PZ2j8jd7_Pbs4vy6vrP5dmvq9KItpnKyqIQvAbJKeuo4KLujenQas0qYZueC4tWsh7aWtpaVgIRemllV3VMWiP4Efmx931M8WnGPKnRZYPe64Bxzoo2tJUgZVMtVLGnmhRzTtirx-RGnXaKglqrVIPaV6nWKhWsgEV28pYwdyPaf6L37hbCzz0Blz-fHSaVjcNg0LqEZlI2uo8S_jcw3gVntH_AHeYhzmnZYflFZaZA3axzrmvSCpYZoeGvp72dpw</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Kirby, J.C</creator><creator>Edwards, E</creator><creator>Kamali Moaveni, A</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Management and functional outcomes following sternoclavicular joint dislocation</title><author>Kirby, J.C ; Edwards, E ; Kamali Moaveni, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c487t-5de443609312b14346fccbedaa254d7f34ded92f0869d6954ee0f9d9b5b29dc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Australia - epidemiology</topic><topic>Closed reduction</topic><topic>Female</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Functional outcomes</topic><topic>Humans</topic><topic>Immobilization - methods</topic><topic>Joint Dislocations - diagnosis</topic><topic>Joint Dislocations - physiopathology</topic><topic>Joint Dislocations - therapy</topic><topic>Joint Instability - diagnosis</topic><topic>Joint Instability - physiopathology</topic><topic>Joint Instability - therapy</topic><topic>Male</topic><topic>Management</topic><topic>Manipulation, Orthopedic - methods</topic><topic>Middle Aged</topic><topic>Neurovascular complications</topic><topic>Open reduction</topic><topic>Orthopedics</topic><topic>Retrospective Studies</topic><topic>Sternoclavicular Joint - injuries</topic><topic>Sternoclavicular Joint - pathology</topic><topic>Sternoclavicular Joint - physiopathology</topic><topic>Sternoclavicular joint dislocation</topic><topic>Trauma Centers - statistics & numerical data</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kirby, J.C</creatorcontrib><creatorcontrib>Edwards, E</creatorcontrib><creatorcontrib>Kamali Moaveni, A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kirby, J.C</au><au>Edwards, E</au><au>Kamali Moaveni, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management and functional outcomes following sternoclavicular joint dislocation</atitle><jtitle>Injury</jtitle><addtitle>Injury</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>46</volume><issue>10</issue><spage>1906</spage><epage>1913</epage><pages>1906-1913</pages><issn>0020-1383</issn><eissn>1879-0267</eissn><abstract>Abstract Introduction The aim of this study is to describe the demographics, management and functional outcomes of patients presenting with a sternoclavicular joint (SCJ) dislocation. Methods A retrospective medical record review was conducted examining patients with SCJ dislocation admitted to an adult level 1 trauma centre between 2004 and 2012. Patient demographics, symptoms, associated injuries, imaging technique used in diagnosis, surgical data and neurovascular complications were recorded. Patients received a single-page questionnaire to assess physical function using two validated shoulder questionnaires. Results A total of 22 patients were identified, out of which 77% sustained a posterior dislocation. Mean age was 30 years (range 16–65), and the most common cause of injury was a direct blow during sport ( n = 11). Open reduction and internal fixation were performed in 13 patients, definitive closed reduction used in seven and two patients were managed expectantly. Functional outcomes for patients were excellent, with American Shoulder and Elbow Society (ASES) and Subjective Shoulder Value (SSV) scores >80 in 87.5% of cases. There were preoperative symptoms consistent with mediastinal compression in 50% and one delayed presentation with thoracic outlet syndrome. No patient had neurovascular compromise or functional deficit post-operatively, regardless of joint congruency. Conclusion This is the largest case series from a single institution currently available examining SCJ dislocation. We recommend an initial trial of closed reduction, followed by open reduction and internal fixation if there is joint instability or malreduction. Functional outcome following both closed and open reduction of the SCJ is excellent.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>26169233</pmid><doi>10.1016/j.injury.2015.05.050</doi><tpages>8</tpages></addata></record> |
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subjects | Adolescent Adult Australia - epidemiology Closed reduction Female Fracture Fixation, Internal - methods Functional outcomes Humans Immobilization - methods Joint Dislocations - diagnosis Joint Dislocations - physiopathology Joint Dislocations - therapy Joint Instability - diagnosis Joint Instability - physiopathology Joint Instability - therapy Male Management Manipulation, Orthopedic - methods Middle Aged Neurovascular complications Open reduction Orthopedics Retrospective Studies Sternoclavicular Joint - injuries Sternoclavicular Joint - pathology Sternoclavicular Joint - physiopathology Sternoclavicular joint dislocation Trauma Centers - statistics & numerical data Treatment Outcome |
title | Management and functional outcomes following sternoclavicular joint dislocation |
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