gms | German Medical Science

Objective: Dislocations of the sternoclavicular joint are rare injuries mainly caused by massive forces applied directly or indirectly to the joint. A high rate of complications has been reported following this injury emphasizing the importance of an accurate diagnosis and therapy.

Material/Methods: We report a series of patients with chronic anterior or posterior sternoclavicular dislocation treated with figure-of-eight gracilis- or semitendinosus-tendon reconstruction. Tendon grafts were collected from the patient’s ipsilateral knee. Preoperative and postoperative DASH scores were compared to evaluate the outcome.

Results: Six patients (mean age: 22 years; range 15 to 46years; male: 3 female: 3) were included in this study. These patients sustained an isolated dislocation of the sternoclavicular joint due a high-energy trauma. Anterior dislocation was observed in 3 patients, posterior instability in 2 patients and the remaining patient showed multidirectional instability. The mean time from injury to operation was 8 months (range 4 to 33 months). The semitendinosus tendon was used in 4 patients, the gracilis tendon in 2 patients, respectively. The latest follow-up examination was after 17 months mean (range 9 to 29 months). The DASH score improved from 54.3 points (range 45.7 to 68.8) preoperatively to 28.8 points (range 25.8 to 34.5) postoperatively.

Conclusion: All patients returned to full activity without limitations including competitive contact sports. Stabilization of the sternoclavicular joint with the figure-of-eight technique seems to be a feasible alternative for young and active patients with remaining instability following conservative treatment.