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http://upload.orthobullets.com/topic/3034/images/clavstern.jpg
http://upload.orthobullets.com/topic/3034/images/sternoclavicular joint.jpg
http://upload.orthobullets.com/topic/3034/images/serendipity view2.jpg
http://upload.orthobullets.com/topic/3034/images/serendipity view.jpg

Introduction
  • Diarthrodial saddle joint incongruous (~50% contact)
    • fibrocartilage (not synovial cartilage)
    • contains an intra-articular disc
  • Motion
    • elevation of arm to 90° leads to rotation of the sternoclavicular joint of 30°
  • Imaging
    • best assessed radiographically by Serendipity view 
      • involves 40° cephalic tilt view of sternum and clavicle 
      • CT scan is most sensitive and specific 
Stabilizing Ligaments of Sternoclavicular Joint
  • Posterior sternoclavicular capsular ligament
    • primary restraint for anterior-posterior stability
  • Anterior sternoclavicular ligament
    • primary restraint to superior displacement of medial clavicle
  • Costoclavicular (rhomboid) ligament
    • anterior fasciculus resists superior rotation and lateral displacement
    • posterior fasciculus resists inferior rotation and medial displacement
  • Intra-articular disk ligament
    • prevents medial displacement of clavicle
    • secondary restraint to superior clavicle displacement
Medial Clavicle Anatomy
  • Clavicle is the first bone to begin the ossification process 
    • ossifies between 5th and 6th weeks of gestation
  • Clavicle is the last bone to complete the ossification process 
    • medial epiphysis of clavicle is last physis to close at 20-25 yrs
  • Important to distinguish SC dislocations from physeal fractures
    • most injuries at this location involve the medial clavicular physis before age of 25
 

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