Pathologien des Sternoklavikulargelenks und deren Therapiemö glichkeiten

In cases of a dislocated sternoclavicular (SC) joint, closed reduction is attempted. This is easy for an anterior dislocation but recurrent dislocation occurs quite often. In this case conservative treatment is the first choice. Closed reduction is difficult for a posterior dislocation and if it not successful the joint has to be reopened but this is dangerous due to the vicinity of the mediastinum. In younger patients dislocations are frequently fractures of the epiphyseal plate. Chronic dislocations which cause pain are treated by open reduction and stabilization with a tendon graft. Non-traumatic instability of the SC joint in younger patients is always treated conservatively. In primary osteoarthritis of the SC joint the medial clavicle may be shortened. In posttraumatic cases the clavicle has to be additionally fixed to the first rib. Arthritis of the SC joint results from a wide variety of chronic inflammatory diseases which like postmenopausal arthritis are treated conservatively. Septic arthritis is a dangerous condition as it may result in mediastinitis, therefore the joint should be surgically treated as early as possible.