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Migrated posterior sternoclavicular joint dislocation into the mediastinum along with clavicle diaphyseal fracture in a child

1 Department of Orthopedic Surgery, Al Noor Specialist Hospital, Makkah, Saudi Arabia
2 Division of Orthopedic, Department of Surgery, College of Medicine, Taif University, Taif, Saudi Arabia

Correspondence Address:
Amaal M Aldosari,
Department of Surgery, Al Noor Specialist Hospital, Makkah
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmsr.jmsr_106_20

The sternoclavicular joint (SCJ) is one of the least frequently dislocated joints, especially in a posterior direction. Posterior SCJ dislocation is a rare injury in orthopedic surgery compared to anterior dislocation, especially in children. The properties of anatomical structures and biomechanics around the SCJ are the primary cause of this rarity. Posterior dislocation may lead to fatal mediastinum injuries. Strict physical examination and diagnostic images should be carefully evaluated if there is any doubt of this injury to avoid delayed or misdiagnosis and complications. The authors report this rare instance of traumatic posterior SCJ dislocation with a middle clavicle fracture, which was associated with the migration of the proximal end into the aortopulmonary window in a 9-year-old child. It was early diagnosed in the Emergency Department by a computed tomography scan. The patient was managed by open reduction with suture fixation, and the stability was assessed intraoperatively. The thoracic surgery team assistance was valuable. The purpose of reporting this unique case is to discuss the rarity of the radiological findings in a child with SCJ dislocation, that is regularly a physeal fracture-dislocation, according to the literature. Furthermore, to discuss our approach to avoid misdiagnosis and complications.

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