The Management of Sternoclavicular Instability

This article outlines the clinical presentations, investigations and the principles behind the available treatment options that can ensure a safe return to a normally functioning shoulder. Instability of the SCJ may happen after a traumatic event or atraumatically with or without joint laxity. The clinician should promptly differentiate the two pathomechanisms as management of them differs significantly. The Stanmore instability triangle is a useful tool when assessing patients with chronic SCJ instability as it enables the clinician to recognise the factors that drive the instability and treat each component separately and in a staged manner. Treatment is dependent on understanding the various factors including the direction of instability, chronicity and pathomechanisms. This could involve conservative management with resting the arm in a sling followed by targeted physiotherapy or surgical management with closed or open reduction and if required, surgical stabilisation with autograft, suture anchors or plating.
Source: Journal of Arthroscopy and Joint Surgery - Category: Orthopaedics Source Type: research