Abstract
Retrosternal dislocation of the clavicle is a relatively rare condition and may be difficult to diagnose if it is not suspected. We have recently experienced two retrosternal dislocation cases with similar mechanisms.
Case 1. A fifteen -year-old boy's posterolateral surface of his right shoulder was struck while playing Rugby and he felt pain in the region of the right sternoclavicular joint. When he visited us he was unable to move his left arm without severe pain. Swelling and tenderness were found over the right sternoclavicular joint. Plain X-rays were interpreted as normal. A computed tomography scan revealed a retrosternal dislocation of the right clavicle.
Closed reduction under general anesthesia was attempted, but it was unsu c cessful. Open reduction was performed and two Kirschner wires were drilled obliquely to fix the right sternoclavicle joint. One month later, one of the Kirschner wires was found to be broken on X-rays and immediately they were removed. At final follow up, two years later, the patient had full range of motion without pain.
Case 2. A fifteen-year-old boy was injured similarly to case 1 during a basketball game. He supported his upper left extremity with his right hand and was unable to move his left arm without severe pain when he came to our hospital. Diagnosis of the left retrosternal dislocation was made on the basis of clinical findings and confirmed by a computed tomography scan. Closed reduction under general anesthesia was unsuccessful. We performed open reduction without internal fixation. At the final follow-up, six months later, the patient had no complaints.
Closed reduction must be attempted not only with standard methods, but also with Buckerfield's method as soon as a diagnosis is established. Open reduction is indicated when closed reduction has failed. Suturing for effective repair is preferable to the use of internal fixation devices to hold the reduction.
