Bilateral, spontaneous, anterior subluxation of the sternoclavicular joint: a case report and literature review

A case of atraumatic, spontaneous, bilateral, sternoclavicular joint subluxation in a 20-year-old man on combat duty in Iraq is reported. There was no history of an underlying pathologic condition and no history of injury to the area. The patient demonstrated recurrent, mildly painful, subluxation whenever either arm was abducted past 80 degrees to 90 degrees. Computed tomographic scans of the joints in both reduction and subluxation were obtained, and pseudodislocation was excluded. The patient was reassured that the subluxation would not affect his upper extremity strength, was treated with conservative measures, and returned to duty. The literature was reviewed for comparison of surgical and nonsurgical options. Surgical stabilization of sternoclavicular joint dislocations is associated with a high incidence of serious complications. Spontaneous sternoclavicular joint subluxations have a benign course and do not fare well after surgical repair. It is recommended that all grade I and II sternoclavicular joint sprains be treated conservatively.