Sternoclavicular Joint Injury Follow-up
- Author: John P Rudzinski, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH more...
Further Outpatient Care
Reductions performed in the ED require stabilization of the affected shoulder with a soft figure-of-eight dressing, a commercial clavicular harness, or secure sling. Maintain immobilization for at least 4 weeks.
To ensure adequate healing of sprains, arrange for a follow-up visit to the appropriate physician after stabilization of the affected shoulder and analgesia.
For anterior/posterior dislocations, a follow-up visit is indicated to determine the need for further treatment (eg, elective reduction, internal fixation) and to evaluate subsequent functional capacity.
Further Inpatient Care
Inpatient admission may be necessary for patients with posterior sternoclavicular joint (SCJ) dislocations or for patients in need of treatment of associated injuries.
Inpatient & Outpatient Medications
Medications include analgesics and/or anti-inflammatory agents
Patients thought to have sustained additional significant injuries, may require transfer to an advanced facility such as a trauma center.
Issues of patient stability and transfer benefit are best addressed based on the clinical setting and available resources.
Patients with posterior SCJ dislocation and/or potential complications may benefit from transfer to a facility with thoracic, vascular, orthopedic or other specialty consultation services.
Posterior SCJ dislocations can be associated with potentially life threatening tracheal, esophageal, vascular, and neurologic injury and may involve the following specific complications:
Pneumothorax or hemothorax
Laceration, compression, or thrombosis of adjacent vascular structures
Neurologic injury including brachial plexus and cerebrovascular injuries
Residual swelling, deformity and/or decreased range of motion
Most patients have adequate upper extremity function following sternoclavicular joint injuries. The prognosis depends on such factors as extent and type of joint damage, activity level, and concomitant medical illness of the patient.
Patients with sprains should initially restrict activity involving the affected extremity.
Patients should restrict activity and follow up as instructed.
Patients with posterior dislocations who are discharged home should return for medical care if they exhibit symptoms of mediastinal injury.
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