SC Joint Disruptions

Classifications
Anterior dislocation
Posterior dislocation
A. Normal B. Posterior Dislocation C. Anterior dislocation
First-degree dislocation : Stable injury, sprain of the supporting ligaments
Second-degree dislocation : Unstable injury, subluxation of the SC joint
Third-degree dislocation : Unstable injury, complete dislocation of the SC joint
Mechanism of Injury
Anterior dislocation : Force applied to the anterolateral aspect of shoulder
Posterior dislocation : Force applied to the anteromedial aspect of clavicle or
posterolateral aspect of shoulder
Examination
Swollen and tender over the SC joint
Exclude pneumothorax, SVC obstruction, neurovascular injury (especially in posterior dislocation)
X-rays : AP view, lateral view, Hobbs view, Serendipity view
Management
First-degree dislocations:
Triangular arm sling, analgesics, TCU Ortho SOC within 2/52
Second-degree dislocations:
Triangular arm sling, figure-of-eight bandaging, analgesics, TCU Ortho SOC 1/52
Third-degree dislocations:
Anterior dislocation: Attempt closed reduction at the A&E
Lateral traction to abducted upper limb with controlled posterior force applied on medial clavicle. Triangular arm sling, figure-of-eight bandaging, check X-rays, analgesics, TCU Ortho SOC 1/52
Posterior dislocation:
Triangular arm sling, analgesics, admit to Ortho Dept stat for immediate reduction under anaesthesia.
Assess for possible airway and great vessel injuries.