Posterior sternoclavicular epiphyseal fracture-dislocation: Case report and review of literature

Posteriorly displaced physeal fractures of the medial clavicle are relatively rare injuries in the growing skeleton and are often confused with the posterior dislocations of the sternoclavicular joint (SCJ). Frequently, these initially undiagnosed due to variable clinical presentation and inadequate visualisation of the joint on plain radiographs. This failure of diagnosis or delayed treatment may lead to serious complications though secondary injuries of mediastinal structures.We present a case report of a 16-year-old male with posterior sternoclavicular epiphyseal fracture-dislocation without vasculonervous injury that occurred in basketball training. The correct diagnosis required multiple modalities over two emergency department visits. Computed tomography with intravenous contrast was the imaging modality of choice for diagnosis. Treatment consisted of attempts at closed reduction, which was not successful. Open reduction was performed with relocation of the clavicle into the periosteal sleeve followed by strong suture material. We have reviewed the literature to provide an insight with regards to correct diagnosis and management of this injury.