Sternoclavicular joint dislocation

　　The common causes of sternoclavicular joint dislocation are not other than direct and indirect violence, with indirect violence being the main cause. The violence usually originates from the lateral side or the abducted upper arm from the shoulder and transmitted inward along the clavicle to the sternoclavicular joint, pushing the clavicular end upward, forward, or backward. The direction of dislocation depends on the size of the violence and the posture of the injury, and can be divided into anterior and posterior dislocations.

　　Posterior dislocation of the sternoclavicular joint can cause respiratory distress, difficulty in swallowing, and circulatory obstruction when the clavicular end moves to the rib after the dislocation, compressing the trachea, esophagus, or mediastinal blood vessels. If the apex of the lung is pierced, subcutaneous emphysema can occur, and the sternoclavicular joint area is empty to the touch.

      The manifestations of sternoclavicular joint dislocation include pain and swelling in the sternoclavicular joint area, forward and lateral flexion of the neck, and any upward or shoulder movement can trigger pain. Deep breathing and sneezing can exacerbate the pain. The joint deformity, relaxation of the medial end of the clavicle, and tenderness (+) are present. In the case of anterior dislocation, the medial end of the clavicle is prominently forwardly protruding, and abnormal movement may be observed. When the clavicle compresses the trachea and esophagus, it can cause a feeling of suffocation and difficulty in swallowing. If the apex of the lung is pierced, subcutaneous emphysema can occur, and the sternoclavicular joint area is empty to the touch.

　　Patients with sternoclavicular joint dislocation should pay attention to calcium supplementation, and the specific preventive and control measures are described as follows.

　　1. Calcium supplementation should be based on dietary intake, and attention should be paid to a balanced diet. Increase the intake of dairy products, and at the same time, expose yourself to sunlight and supplement vitamin D to promote calcium absorption. If necessary, supplement calcium agents in moderation, such as calcium gluconate or JueNeng Calcium, which are commonly used, cost-effective calcium supplements in clinical practice. However, it is important to supplement calcium under the guidance of a doctor. Vitamin D is the carrier for calcium ions to be absorbed by the bone marrow. The Calcium Yuan tablet contains vitamin D, which can significantly increase the absorption of calcium ions by the body.

　　2. Adhere to moderate physical exercise to prevent osteoporosis. Regular exercise can help protect joints and prevent the occurrence of osteoarthritis by strengthening the supporting effects of muscles, tendons, and ligaments.

　　The diagnosis of sternoclavicular joint dislocation is made by X-ray imaging examination, and it is best to take oblique or lateral X-ray films, combined with the history of trauma for diagnosis. The chest anteroposterior X-ray film often fails to detect the condition. In such cases, routine CT scanning should be performed, and complications can be identified at the same time. The diagnosis of sternoclavicular joint dislocation mainly relies on clinical manifestations and imaging examinations. Since the sternoclavicular joint is located subcutaneously and the clavicular end is relatively thick, local pain, swelling, and tenderness are particularly obvious after the sternoclavicular joint dislocation. In the case of anterior dislocation of the sternoclavicular joint, the clavicular end appears prominent and forwardly displaced, and sometimes abnormal movement can be seen. Comparison of the two sides of the sternoclavicular joints shows more obvious deformity. Confirmation is often possible through palpation and X-ray lateral oblique films.

　　Patients with sternoclavicular joint dislocation should consume more protein-rich foods and supplement calcium appropriately. The specific dietary precautions are described as follows.

　　1. Suitable diet for sternoclavicular joint dislocation

　　Enhance nutrition, eat more protein-rich foods such as fish, eggs, and soy products. Increase calcium appropriately. Drink more water, eat more vegetables and fruits such as green vegetables, celery, and bananas.

　　2. Dietary taboos for sternoclavicular joint dislocation

　　Avoid spicy foods, such as chili and mustard. Bad habits such as smoking and drinking should be戒除.

　　Sternoclavicular joint dislocation is divided into surgical treatment and non-surgical treatment, and the specific treatment methods are described as follows.

　　Firstly, Non-surgical Treatment for Sternoclavicular Joint Dislocation

　　1. Mild injury, mainly symptomatic treatment. The upper limb is suspended with a triangular bandage. In the first 24 to 36 hours, local cold compresses are used, and then hot compresses are applied. Gradually implement exercise activities 4 to 5 days later, and generally recover completely in 10 to 14 days.

　　2. Both subluxation and anterior dislocation can be treated with closed reduction, abduction traction, and manual pressure on the proximal end of the clavicle. After reduction, the clavicle is fixed with a pre-'8' shaped plaster. Most posterior dislocations can be treated with closed reduction. After local anesthesia, the patient lies on his back, with sandbags placed between the scapulae. The patient's upper arm hangs outside the bed, and the assistant pulls down. The operator holds the clavicle with both hands, pulling the medial end of the clavicle upwards, forwards, and outwards. When the joint is reduced, a sound can be heard, and the clavicle's medial end can be felt immediately. After reduction, the shoulder is fixed with an '8' shaped plaster bandage, and it is removed after 6 weeks. If manual reduction is unsuccessful, a towel clip can be used to pull the proximal end of the clavicle forward for reduction.

　　Secondly,Surgical Treatment for Sternoclavicular Joint Dislocation

　　1. Open reduction and Kirschner wire internal fixation. Indicated for patients with posterior dislocation who cannot be reduced closed and have symptoms of tracheal and esophageal compression.

　　2. Arthroscopic meniscectomy or excision of the medial segment of the clavicle. For patients with old traumatic dislocation who require treatment, excision of the distal end of the clavicle can be adopted. Any internal fixation method can affect joint movement and should not be used. Gradual anterior dislocation of the sternoclavicular joint due to chronic traumatic injury does not require special treatment if there is only local swelling.