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- Talk
- 14/07/2021
- UK
Sternoclavicular Joint Instability in Sports Injuries
Description
In this presentation, Graham Tytherleigh-Strong, an orthopedic surgeon at Addenbrooke's Hospital in Cambridge, discusses sternoclavicular joint (SCJ) instability related to sports injuries. He begins by explaining the anatomical features that stabilize the SCJ, highlighting the limited bony congruence and the important role of ligaments and dynamic stabilizers like muscles. Tytherleigh-Strong distinguishes between atraumatic and traumatic instability, emphasizing a recent understanding that atraumatic instability can result from complex interactions involving muscular patterns and structural laxity, particularly in younger athletes.
He details the treatment rationale, primarily focusing on physiotherapy for atraumatic cases while acknowledging that surgical intervention may be necessary in rare instances of persistent joint laxity. The presentation addresses the common occurrence of traumatic dislocations, pointing out that many dislocated joints may spontaneously relocate, thus complicating assessment.
Tytherleigh-Strong explains the mechanisms by which SC joint dislocations occur, with particular emphasis on the importance of differential diagnosis during shoulder injuries. He discusses appropriate imaging techniques, noting the limitations of CT scans for soft-tissue evaluation and the advantages of MRI scans for assessing SC joint injuries.
The discussion covers various treatment approaches, advocating for open surgical techniques in cases of dislocation, particularly posterior dislocations, where significant vascular concerns may arise. He supports the idea that while acute management of these injuries is vital, the urgency often can be overestimated, and a structured approach to rehabilitation and surgical correction can yield excellent outcomes. Tytherleigh-Strong concludes by reiterating the need for heightened awareness among clinicians regarding SC joint injuries, particularly in active individuals, and outlines a cautious, methodical approach to diagnosis and management.