Ipsilateral posterior sternoclavicular dislocation and fracture of the medial third clavicle: a case report
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Sternoclavicular joint
Neurovascular bundle
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Osteomyelitis of clavicle is an uncommon disease.In children its origin is generally haematogenous and in adults it is more commonly a secondary infection seen in association with predisposing factor.We are reporting a case of clavicle osteomyelitis in an 8 year female child.Patient presented with us with exposed medial 1/3rd of clavicle with subluxated sternoclavicular joint with abscess around the clavicle.X ray was predominantly sclerotic.Patient was managed by excision of projected medial end of clavicle and I/v antibiotic.Excised fragment sent for histopathological examination confirmed the diagnosis of chronic osteomyelitis.Postoperatively patient achieved normal range of movements of involved upper limb.Primary osteomyelitis of clavicle is very rare disease.The radiographic findings in clavicular osteomyelitis are frequently not diagnostic and histopathological examination of the diseased bone is usually required to confirm the diagnosis.The management includes both medical and surgical strategies.A large part of the clavicle can be excised without significant loss of function.
Sternoclavicular joint
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Subluxation
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Fractures of the medial third of the clavicle are the rarest of all clavicle fractures. We present two cases of medial clavicle fracture nonunions that were initially thought to be chronic anterior sternoclavicular dislocations and describe the entity of pseudo-dislocation of the sternoclavicular joint. Computed tomography should be performed on all patients with suspected or established injuries of the sternoclavicular region to ensure differentiation between fracture and dislocation.
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♦ Fractures and dislocations of the sternoclavicular joint are uncommon and often successfully treated non-operatively ♦ There are a number of poorly defined sclerotic, sometimes inflammatory, conditions with a predilection for the medial clavicle.
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Posterior dislocation of the clavicle at the sternoclavicular joint is rare. Nonetheless, prompt diagnosis is important because the posteriorly displaced clavicle may produce serious morbidity and even death. Symptoms are variable, depending on the structures in the superior mediastinum affected. A special simple x-ray projection (the “Heinig” projection) which has been found extremely useful in the diagnosis of sternoclavicular dislocations is described. Radiographs of posterior and anterior dislocations are compared.
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Neurovascular complications associated with recent or old fractures or dislocations of the clavicle are rare. Fourteen cases of this type of complication are reviewed and the diagnosis, prevention, and treatment are discussed.
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Non-traumatic pathological sternoclavicular joint dislocation due to medial end of clavicle osteomyelitis is extremely rare. This kind of rare complication should be anticipated while encountering these kinds of cases. A sixty-three-year-old male came with pain and swelling over the left neck and was diagnosed to have left clavicle osteomyelitis. The unexplored complication of sternoclavicular joint dislocation and successful management of such complications has been discussed in this case report. To best of our knowledge this is the first case report of a non-traumatic pathological sternoclavicular joint dislocation due to clavicle osteomyelitis. This case report will supplement the inadequate literature in management of such cases.
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Sternoclavicular joint
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Sternum
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