Posterior Sternolclavicle Dislocation

Hello, I am not sure if I am supposed to be in these forums but I just cannot find Longterm information regarding an ijnjury 2 week ago.

I'm a 29 year old Male. -

About 2 weeks ago I injured myself resulting a Posterior Sternolclavical Dislocation - Given its rareity there is not a lot of research done on this regarding the healing process and longterm complications.

I was Treated in a great hospital - It was 5 days until I went under for closed reduction with no complications getting it back in - I am currently seeing a Sports physio who is well respected and highly creditable - She has never treated this before and is doing what ever she can to find information on this. She is treating this like any other dislocation for the time being and I do trust her.

Dislocations has its complications so im also looking for longterm answers.

If someone could answer these questions best they could would be great and much appreciated.

With I suffer longterm complications?

Will I be able to endure my regular physical sports a year from now and not risk dislocation again?

If I dislocate it again - can it pop out faster and result in death as usually is the case of this type of injury?

What can I do to ensure the ligaments tighten and heal properly?

Is there a way to find out if the ligaments did heal properly all around the joint?

Is my joint weaker as most other common dislocations are such as shoulder dislocations?

Or does the body have a backup plan because the type of injury this is it would heal better then most other joints?

If anyone could please offer me any information you have it would be great. I am very physically active and I am not taking this too well so I am looking for as much information if I need to prepare myself mentally that I will not be able to do many of my activies because of the risk it may involve rupturing artiers and perhaps puncturing a lung.

Thank you very much,

Michael<br><br>Post edited by: Skorah, at: 2007/07/15 16:46

You are correct. There is limited information about the long term outcomes following posterior sternoclavicular dislocations. The primary reason has to do with the small number of cases in the literature. Anterior sternoclavicular dislocation account for 90-95% while posterior only 5-10%.

There are no real guidelines for many of the questions you have asked.

Will I suffer longterm complications?
If you avoided any significant injuries with the initial injury (ie. no injury to the blood vessels, lungs or trachea then the most common long term complications are development of arthritis in the joint and possible recurrent instability. There is little data in the literature to provide exact numbers.

Will I be able to endure my regular physical sports a year from now and not risk dislocation again?
Yes. I would be very surprised if you were not able to do all sports. Assuming the reduction was successful and stays in place then your risk of re dislocation is probably only 5-10%. Again, there is little literature to support this for posterior dislocations. Most recurrent dislocations occur with anterior dislocation.

If I dislocate it again - can it pop out faster and result in death as usually is the case of this type of injury?

I would estimate that your risks of injury to the blood vessels is at most only slightly higher than with the initial injury. The estimated risks of a complication from a posterior sternoclavicular joint are 25%.

What can I do to ensure the ligaments tighten and heal properly?

Don't do too much too soon. How long is too soon? No one really knows but I would definitely avoid contact sports or other activities (ie. if you can hit the ground or a wall consider it a contact sport) for 3 months minimum.

Is there a way to find out if the ligaments did heal properly all around the joint?

Clinical exam is probably as realiable as any other test. An MRI will show lots of changes in the soft tissues for a long time and would not clearly show the ligaments.

Is my joint weaker as most other common dislocations are such as shoulder dislocations?

Again, there is no good evidence to answer this question but based on other joint dislocation it most likely will have some increased mobility/motion compared to the other side. You might also notice that it remains more swollen than the other side.

Or does the body have a backup plan because the type of injury this is it would heal better then most other joints?

No backup plan. Give the body time to heal itself. Don't do too much too soon. Avoid contact sports/activities for 3-6 months minimum.

Great questions. Unfortunately there is little in the literature to provide you with well supported answers.

Regards

Christian

Hello

I thought I would give an update on my condition. I hope this will help as there is very little literature on this. What I will do is go through a list what I have been doing since my release from the hospital.

1. The first week left me very sory after surgery and I was off the perks in 2 days. I took one every now and then depending if I rolled over in my sleep. I went back to work (self employed) and only deligated my employees.

2. The 2nd week I was able to move my arm at 60% and every now and then I picked up a hard rake and started grading soil as it is extremly hard for me to just sit there and do nothing. That evening I was in a bit of pain. The pain was soreness from using it and not pain of getting worse. As the days went by I was able go with out pain and reduced to being sore. I started self physiotherapy.

3. At the end of the 3rd week I took off my figure eight brace. I increased my physical work habbits. I was able to move wheel barrels around with some pain but managable and kept with in my limits. I sleep on my back as there is no other position allowing you to do so.

4. The 4th week, pain is less and less. I am still sleeping on my back.

5. 5th week I have increased my work load but still limited. Lifting more then 30 pounds causing some pain but manageable. I am not able to lift more more then 30 pounds..

6. 6th week I have full rotation of my arm but I am still limited to lifting as it puts pressure on the area causing discomfort. I lift within my limits.

7. 7th week I am able to lift wheel barrals and dump them ranging up to 100 pounds. i am still sleep on my back. If I wake up on my side I can feel the stretching in the ligaments and discomfort for 30 minutes after getting out of the position. Sneezing hurts a little. Do not turn your head to sneeze as it becomes painful. The pain in the joint is 90% gone.

8. 8th week - The pain is 95% gone. I still limited to what I can lift. I am able to lift my own body weight with no pain at all. WhenI do feel discomfort or little pain is when I lift bending over as it seems to put the joint in a free position to move around. Sleeping on my side is still not something I do. I am able to sleep on my stomach with some discomfort.


Over all there is sometimes some pain but mostly discomfort. I have a landscape design company and I am working at 70%. I am riding a mountain bike time to time on flat surfaces. I am in no condition to take any physical impact on the shoulder. I know I still have a long way to heal and I expect it to take a 8 months I would guess. I am able to phyically work, drive, mountain bikiing, run, but again depending how I move it can cause light light pain. I am trying very hard not to over do it and I know I am over doing it way to much but I cant help it. What I am doing is not making it worse. I had a follow up and they said they are very suprized how well it has come along. I wil be going for an MIR soon. I will also have the pictures soon showing the Posterior Dislocation and one after at 9 weeks.

If anyone has any questions please ask me and I will be gladly to respond and help out in anyway in the months to come.

It would be great if someone took my information and reworded it for literature you can use. My case would be a \&quot;best case senario\&quot; as it seems. I am not in the clear yet.

Michael

Hello

I thought I would give an update on my condition. I hope this will help as there is very little literature on this. What I will do is go through a list what I have been doing since my release from the hospital.

1. The first week left me very sory after surgery and I was off the perks in 2 days. I took one every now and then depending if I rolled over in my sleep. I went back to work (self employed) and only deligated my employees.

2. The 2nd week I was able to move my arm at 60% and every now and then I picked up a hard rake and started grading soil as it is extremly hard for me to just sit there and do nothing. That evening I was in a bit of pain. The pain was soreness from using it and not pain of getting worse. As the days went by I was able go with out pain and reduced to being sore. I started self physiotherapy.

3. At the end of the 3rd week I took off my figure eight brace. I increased my physical work habbits. I was able to move wheel barrels around with some pain but managable and kept with in my limits. I sleep on my back as there is no other position allowing you to do so.

4. The 4th week, pain is less and less. I am still sleeping on my back.

5. 5th week I have increased my work load but still limited. Lifting more then 30 pounds causing some pain but manageable. I am not able to lift more more then 30 pounds..

6. 6th week I have full rotation of my arm but I am still limited to lifting as it puts pressure on the area causing discomfort. I lift within my limits.

7. 7th week I am able to lift wheel barrals and dump them ranging up to 100 pounds. i am still sleep on my back. If I wake up on my side I can feel the stretching in the ligaments and discomfort for 30 minutes after getting out of the position. Sneezing hurts a little. Do not turn your head to sneeze as it becomes painful. The pain in the joint is 90% gone.

8. 8th week - The pain is 95% gone. I still limited to what I can lift. I am able to lift my own body weight with no pain at all. WhenI do feel discomfort or little pain is when I lift bending over as it seems to put the joint in a free position to move around. Sleeping on my side is still not something I do. I am able to sleep on my stomach with some discomfort.


Over all there is sometimes some pain but mostly discomfort. I have a landscape design company and I am working at 70%. I am riding a mountain bike time to time on flat surfaces. I am in no condition to take any physical impact on the shoulder. I know I still have a long way to heal and I expect it to take a 8 months I would guess. I am able to phyically work, drive, mountain bikiing, run, but again depending how I move it can cause light light pain. I am trying very hard not to over do it and I know I am over doing it way to much but I cant help it. What I am doing is not making it worse. I had a follow up and they said they are very suprized how well it has come along. I wil be going for an MIR soon. I will also have the pictures soon showing the Posterior Dislocation and one after at 9 weeks.

If anyone has any questions please ask me and I will be gladly to respond and help out in anyway in the months to come.

It would be great if someone took my information and reworded it for literature you can use. My case would be a \&quot;best case senario\&quot; as it seems. I am not in the clear yet.

Michael