Evolution of nonoperative treatment of atraumatic sternoclavicular dislocation
Journal of Shoulder and Elbow Surgery Jul 30, 2019
Moreels R, et al. - All subjects with atraumatic sternoclavicular dislocation (ASCD) who visited the department between 2011 and 2016 were retrospectively assessed by the researchers in order to better define the clinical picture of ASCD and to describe the outcomes of a “wait-and-see” policy in these subjects. Twenty-three subjects were assessed. The average age at diagnosis was estimated to be 18.6 years. In comparison with abduction, a notable variation in the angle of dislocation during the forward flexion was observed. In relation to the presentation at initial diagnosis in 19/23 subjects, subluxations still occurred at the latest follow-up, however, they were less common and less prominent. For each year of follow-up, the likelihood of subjective improvement progressed by 27%. High result scores of Nottingham Clavicle Score, Oxford Shoulder Score, and Constant-Murley Score were noted. Hence, the clavicle subluxated earlier in abduction than in the forward flexion, in subjects with ASCD. A “wait-and-see” policy does not fix the subluxations, following a midterm follow-up. Nevertheless, most patients displayed decreased recurrence and severity of subluxations over their recovery period and exhibited excellent scores on shoulder questionnaires.
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