From the Research
A sternoclavicular fracture is a break in the joint where the collarbone (clavicle) meets the breastbone (sternum), typically diagnosed through physical examination and imaging studies, such as X-rays or CT scans, and treatment depends on the severity of the fracture but often involves conservative measures. The diagnosis of a sternoclavicular fracture is crucial for determining the appropriate treatment plan.
- The treatment plan may include rest, ice application, and pain management with over-the-counter medications like ibuprofen or acetaminophen 1.
- A sling or figure-of-eight brace may be used for 2-6 weeks to immobilize the joint and promote healing 2.
- In severe cases or those with significant displacement, surgical intervention may be necessary, such as the use of a precontoured plate designed for the contralateral distal clavicle, and medial fixation accomplished at the sternum 3.
- Physical therapy is often recommended after the initial healing period to restore range of motion and strength.
- Most sternoclavicular fractures heal well with appropriate treatment, but complications such as chronic pain or limited mobility can occur in some cases, as seen in the study by 4, which reported a case of a 14-year-old adolescent with a Salter-Harris II fracture and posterior displacement of the diaphysis.
- The study by 5 compared the treatment of fracture midshaft clavicle in adults by external fixator with conservative treatment and found that the external fixator group had a shorter union time and better Constant score at 6 months.
- However, the most recent and highest quality study, 3, reported a case of a 29-year-old man with a displaced medial clavicle fracture who underwent surgical repair using a precontoured plate and had no complications and demonstrated full strength and range of motion at the 8-month follow-up.
- Therefore, the recommended approach for treating a sternoclavicular fracture is to use conservative measures for most cases, but surgical intervention may be necessary in severe cases or those with significant displacement, and physical therapy is often recommended after the initial healing period to restore range of motion and strength. It's essential to follow up with a healthcare provider to ensure proper healing and address any ongoing issues, as complications can occur even with appropriate treatment, as reported in the study by 2, which compared the treatment of mid-shaft clavicular fractures by non-operative treatment and plate fixation in 60 patients.