Cook Victoria, Norquay Miranda, Moopanar Terence, Brady Peter
Cardiothoracic Department, Royal North Shore Hospital, Sydney, Australia.
Department of Orthopaedic Surgery, Royal North Shore Hospital, Sydney, Australia.
Trauma Case Rep. 2023 May 29;46:100856. doi: 10.1016/j.tcr.2023.100856. eCollection 2023 Aug.
Posterior dislocation of the sternoclavicular joint (SCJ), although uncommon, can be life-threatening. Displacement of the clavicular head poses a threat to the vital structures of the mediastinum. We describe the case of a 15-year-old boy with traumatic Salter Harris II medial clavicular fracture with posterior dislocation of the metaphysis resulting in impingement of the aortic arch, left subclavian and common carotid artery, as well as partial obstruction of the brachiocephalic vein. We describe the novel use of video-assisted thoracoscopy to assist with a safe open reduction and fixation of the fracture dislocation. The case highlights the importance of computer tomography imaging for diagnosis of posterior SCJ fracture/dislocations and the early recognition of potential life-threatening complications in the mediastinum.
胸锁关节（SCJ）后脱位虽不常见，但可能危及生命。锁骨头部的移位对纵隔的重要结构构成威胁。我们描述了一名15岁男孩的病例，其患有创伤性Salter Harris II型内侧锁骨骨折，干骺端后脱位，导致主动脉弓、左锁骨下动脉和颈总动脉受到压迫，以及头臂静脉部分梗阻。我们描述了电视辅助胸腔镜在协助安全切开复位及固定骨折脱位方面的新应用。该病例凸显了计算机断层扫描成像在诊断SCJ后骨折/脱位以及早期识别纵隔潜在危及生命并发症方面的重要性。
