Sternoclavicular Dislocations

SC joint
The sternoclavicular joint is the joint between the end of the clavicle and the sternum (white circle).
The sternoclavicular joint is the joint between the clavicle (collarbone) and sternum (breast bone). It is an uncommon injury when you consider all shoulder injuries. It typically occurs in contact and collision sports, such as football and rugby. It is a very painful, and potentially dangerous, injury, and a sports medicine physician should see athletes who are suspected of having this injury immediately.

Typically the athlete is injured with a direct blow, either to the chest or shoulder. Depending on the direction of the force, a blow to the shoulder can cause an anterior or posterior sternoclavicular dislocation. An anterior dislocation of this joint means that the collarbone has popped out in front of the sternum. A posterior dislocation means that the collarbone has gone behind the sternum. While both types of dislocations are very serious, a posterior dislocation can be a surgical emergency, as the end of the collarbone becomes extremely close to the airway and large blood vessels of the heart and chest.

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The athlete will complain of pain in the shoulder and/or chest immediately. He likely will have difficulty moving the arm due to the pain. Posterior dislocations can often cause the athlete to have difficulty breathing, and the physician may notice that he is short of breath or wheezing.

Posterior sternoclavicular dislocation
Note how the end of the left clavicle (which is the one on the right in the image) has dislocated behind the sternum.
Physical examination usually shows that the end of the collarbone is very prominent on the injured side if it is an anterior dislocation, and the athlete will be very tender at that location. Evaluation with x-rays, and a CT scan if needed, is critical, so I send players with suspected sternoclavicular dislocations to the emergency room right away.

Posterior sternoclavicular dislocation
On this three-dimensional CT scan, note how close the dislocated clavicle is to the large blood vessels of the chest. This injury needs urgent reduction.
Treatment of these injuries depends on the direction of the dislocation. Anterior dislocations can be put back in place with gentle pressure on the clavicle, pushing it back in line with the sternum. Sometimes it’s difficult to reduce into the proper position, or it pops back out of place, but fortunately an anterior dislocation leaves only a cosmetic deformity. Usually little long-term functional deficit exists after the athlete has recovered.

A posterior dislocation, on the other hand, needs urgent reduction. Whether this reduction is done in the emergency room or the operating room is controversial. The clavicle needs to be reduced back into place with the sternum to prevent the clavicle from causing injury to the blood vessels and airway nearby. Occasionally surgery to open the joint and manually put the clavicle back into place is needed.

If you have specific questions about sternoclavicular dislocations, please Ask Dr. Geier directly or Schedule an Appointment.

14 Responses to Sternoclavicular Dislocations

  1. Hi,
    I’m a 14 year old swedish boy that dislocated my collarbone by the sternum two days ago and I have a big rugby game in 5 weeks.
    Will I be able to play?

    • Generally athletes can return to play when pain, swelling, motion, and strength return to normal after an anterior SC dislocation.

  2. I was involved in a bicycle crash on June 6. I have a broken 4th rib in my back.also my doctor says that Ihave a anterior collarbone – sternum dislocation .there’s not much pain in the collar bone. Some clicking though Full range of colours in bruising on right side of chest. doc says to just leave it alone ,and start doing some light range of motion exercises .In your opinion is this the correct course of action ?I was in the whirlpool today and did some easy yoga moves,good results. Not using sling , able to drive car ,shift gears. Am I making things better or worse? Using less Ibuprofen each day.

  3. I have a dislocation in both my right AC & SC joints, they both make the clavicle to appear raised to the outside (piano-key), the displacement is about half centimeter (quarter inch) near the AC end and quarter centimeter (eighth of an inch) from the SC end of the clavicle, is there away to force the clavicle into its place manually without surgery?
    (if so please what’s this process called, and what specialist should I be seeing?). Thank you so much.

    • Typically it is not possible to reduce the clavicle and keep it in place without a surgical procedure. Depending on the extent of injury, though, many patients do not need surgery to regain full function.

  4. Hi
    Three months ago I suffered from an anterior SC dislocation I now have full range of motion with little to no pain on my on my collarbone. But I’m not sure if it healed properly the bone is still patruding and I get a lot of pain when I reach over the opposite shoulder and try to grab my shoulder blade! So does that maybe mean it’s still dislocated??? Oh yeah and for some reason I get a lot of pain on my SC joint out to my shoulder when I smoke pot.

  5. I’m a previously healthy 43 year old woman. Diagnosed with a posterior and superior sc dislocation. After figure 8 surgery clavicle still moves around causing pain/thoracic outlet syndrome and claw-hand symptoms. (And much more)
    If you have experienced similar, please respond here, or at my email. I am searching for doctors with expertise that can help. Thank you for your time. H

  6. My 14 yr old has a anterior dislocated SC joint doctor says all of the things that are said here about recovery just not clear on how you can manage after it heals and you get range back he plays sports what is he gets hit there in a yr will it make it worse. What about lifting weights or anything really. Will it move out of place then. Just confused he people can do everyday things even with it slightly out of place.

  7. My daughter dislocated her anterior SC about 3 months ago while diving off of 5 meter platform. She took a few days off but continued to dive after she was no longer in pain.i took her to the doctor after she noticed that it was popping on and out. Just recently a trainer told her that she has instability there and will not be able to strengthen her shoulder muscles unless it heals. Should she continue to dive? Should she strengthen her muscles. She has had a lot of rotator cuff pain and pectoral strains in the same side maybe due to the SC issue.

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