Anterior Sternoclavicular Joint Dislocation Classification and Management: A Review of the Literature.

JBJS Rev · Apr 01 2025 · Review

El Zouhbi A, Hammad A, Hammad M, Nassereddine M

Department of Orthopedic Surgery, American University of Beirut Medical Center, Beirut, Lebanon

Shoulder & Elbow Sports Medicine

SUMMARY — THE REDUCTIONReview finds closed reduction suits most acute anterior SCJ dislocations, but recurrent/symptomatic cases need individualized surgery (suture/internal brace, tendon autograft, or plating) based on activity and bone quality.
Abstract, as published

» Closed reduction and physical therapy are the primary approaches for most acute anterior sternoclavicular joint (SCJ) dislocations, with acceptable outcomes for low-demand patients. However, these treatments have a high rate of recurrent instability, albeit with minimal functional impact.» Persistently symptomatic recurrent dislocations typically warrant surgical intervention. The choice of technique-ranging from nonabsorbable sutures to tendon autografts and plating-is based on individualized care by considering patient-specific factors such as activity level, bone quality, and health.» High-demand patients, such as athletes, benefit from robust techniques like suture repair with an internal brace or hamstring tendon autografts. These methods provide durable stability and reduce recurrence risks.» Patients with poor bone quality, such as those with osteoporosis, may require plating techniques (e.g., locking plates or SCJ-specific plates) to ensure rigid fixation, albeit with potential hardware-related complications.» Owing to the rarity of the condition and limited studies, no standardized treatment protocol exists. Tailored approaches based on clinical and functional needs yield optimal outcomes, and further research is needed to identify the best practices.

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