Asymptomatic fibrous non-union of displaced sternoclavicular epiphyseal fractures: Case report and literature review

Oyekanmi, C.; Higgins, Gussie R.; Nwachukwu, Ijeoma

doi:10.1016/j.injury.2004.12.055

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…They postulated that patients presenting 4–6 weeks after a medial clavicle PI may have a significant deformity due to osseous overgrowth and may require a resection arthroplasty or a more complex reconstruction. In a case report by Oykenami et al17 a 16-year-old male patient who had presented with an acute left clavicle midshaft fracture was noted to have an incidental asymptomatic fibrous nonunion at the medial end of the clavicle. The patient recounted an injury at the medial end of his clavicle 2 years previously from which he had made a full recovery.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging in the Management of Significantly Displaced Adolescent Posterior Sternoclavicular Joint Injuries

Tytherleigh-Strong

Cuthbert

Poutoglidou

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Computed tomography (CT) scans are the standard imaging modality for the diagnosis and treatment guide for adolescent posterior sternoclavicular joint (SCJ) injuries. However, the medial clavicular physis is not visualized and it is not possible to differentiate between a true SCJ dislocation and a physeal injury (PI). An magnetic resonance imaging (MRI) scan can visualize the bone and the physis. Methods: We treated a series of patients with adolescent posterior SCJ injuries diagnosed on CT scan. Patients underwent an MRI scan to differentiate between a true SCJ dislocation and a PI and to further differentiate between a PI with or without residual medial end clavicular bone contact. Patients with a true SCJ dislocation and a PI with no contact underwent an open reduction and fixation. Patients with a PI with contact were treated nonoperatively with repeat CT scans at 1 and 3 months. At final follow-up SCJ clinical function was assessed using Quick-DASH, Rockwood, modified Constant, and single assessment numeric evaluation (SANE) scores. Results: Thirteen patients (2 female and 11 male) with an average age of 14.9 years (12 to 17) were included in the study. Twelve patients were available at final follow-up (mean 50 mo, 26 to 84). One patient had a true SCJ dislocation and 3 had an off-ended PI and were treated with an open reduction and fixation. Eight patients had a PI with residual bone contact and were treated nonoperatively. For these patients serial CT scans showed that the position was maintained, with a serial increase in callus formation and bone remodeling. The average follow-up was 42.9 months (24 to 62). At final follow-up the mean Quick-disabilities of the arm, shoulder and hand (DASH) was 0.4 (0 to 2.3), Rockwood was 15, modified Constant was 98.8 (89 to 100) and SANE was 99.5% (95 to 100). Conclusion: In this case series of significantly displaced adolescent posterior SCJ injuries MRI scans allowed identification of true SCJ dislocations and off-ended PIs, which were successfully treated by open reduction, and PIs with residual physeal contact which were successfully treated nonoperatively. Level of Evidence: Level IV—case series.

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Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging in the Management of Significantly Displaced Adolescent Posterior Sternoclavicular Joint Injuries

Tytherleigh-Strong

Cuthbert

Poutoglidou

et al. 2023

Journal of Pediatric Orthopaedics

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“…Le décollement de l’épiphyse médiale peut survenir de façon concomitante à une luxation acromio-claviculaire [ 21 ] ou à une fracture de la clavicule ipsilatérale. Cette dernière association est souvent retrouvée chez l’adolescent victime d’une chute sur la ceinture scapulaire à gauche [ 12 , 22 – 26 ]. Le déplacement du fragment libre se fait en pivotant en arrière d’au moins 120° à partir du foyer de fracture situé à l’union du 1/3 médial et du 1/3 moyen ou en médio-claviculaire.…”

Section: Discussionunclassified

Fracture-décollement de l’épiphyse médiale de la clavicule: à propos de 6 cas et revue de la littérature

Kasse¹,

Limam²,

Diao³

et al. 2016

Pan Afr Med J

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Le but de ce travail est de décrire les caractéristiques épidémiologiques et les différentes entités anatomo-cliniques de la fracture-séparation de l’épiphyse claviculaire médiale mais également de rapporter les résultats morphologiques et fonctionnelsde de la réduction sanglante suivie de l’ostéo-suture au fil non résorbable. Cinq garçons et 1 fille âgés en moyenne de 14 ans ont présenté un traumatisme fermé et isolé de la ceinture scapulaire. L’examen clinique et l’imagerie médicale surtout la TDM ont permis de poser le diagnostic de décollement épiphysaire, de classer le degré d’ossification de l’épiphyse claviculaire médiale en précisant le sens du déplacement, ainsi que la nature du décollement selon Salter-Harris. Une réduction sanglante suivie d’une ostéo-suture au fil non résorbable décimale n°1 a été réalisées chez 3 patients. Un patient a bénéficié d’un embrochage croisé. Les deux plus jeunes ont été traités orthopédiquement. Le déplacement du moignon claviculaire était antérieur chez 3 patients et rétro-sternal chez les 3 autres. Les formes postérieures ont été compliquées d’une odynophagie (n=2) et d’une compression asymptomatique de la veine sous Clavière (n=1). L’une des formes postérieuresétait associée a une fracture ipsilatérale du 1 / 3 médial de la clavicule. La consolidation a été obtenue chez tous les malades avec une mobilité de l’épaule conservée. La fracture-décollement de l’extrémité médiale de la clavicule mime au plan clinico-radiologique la luxation sterno-claviculaire. Elle peut être grave en raison du risque de compression viscérale et vasculaire dans sa forme postérieure. La tomodensitométrie reste irremplaçable pour un diagnostic précis. Notre préférence va à la réduction sanglante suivie d’une ostéo-suture au fil non métallique.

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Management of sternoclavicular dislocation in young children: considerations about diagnosis and treatment of four cases

et al. 2013

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The records of 4 children of under 14 years of age treated at our institution for traumatic sternoclavicular dislocation (SCJ) were reviewed. Closed reduction in posterior SCJ after computed tomography (CT) was successful as immediate procedure. For anterior SCJ instability, open reduction and SCJ reconstruction obtained satisfactory results. Conservative treatment of SCJ subluxation for asymptomatic children was sufficient. Radiographs in "serendipity view" were useful for confirming reduction and stability in children. No postoperative CT was needed for this purpose. Closed reduction in posterior SCJ dislocation and surgical treatment in anterior SCJ dislocation in young children can provide stability and a satisfactory return to a normal function, but with some limitation when intense or competitive shoulder motion is required during sport. Young children and parents should be aware about this possibility. Conservative treatment of SCJ subluxation for asymptomatic children is useful. Reflection is required regarding the correct imaging examination after treatment to check stable reduction in a SCJ injury.

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Asymptomatic fibrous non-union of displaced sternoclavicular epiphyseal fractures: Case report and literature review

Cited by 5 publications

References 12 publications

Magnetic Resonance Imaging in the Management of Significantly Displaced Adolescent Posterior Sternoclavicular Joint Injuries

Magnetic Resonance Imaging in the Management of Significantly Displaced Adolescent Posterior Sternoclavicular Joint Injuries

Fracture-décollement de l’épiphyse médiale de la clavicule: à propos de 6 cas et revue de la littérature

Management of sternoclavicular dislocation in young children: considerations about diagnosis and treatment of four cases

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