Technique Spotlight: Sternal Docking Technique for Sternoclavicular Joint Instability

Indications

Sternoclavicular joint dislocations occur secondary to trauma or develop spontaneously in patients with collagen disorders, such as Ehler-Danlos syndrome. They are anatomically classified as either anterior or posterior, and further classified as acute or chronic. Joint reconstruction is generally indicated for patients with acute posterior dislocations, which have failed closed reduction, and for patients with chronic instability who have failed nonoperative management. Occasionally, medial clavicle resection and ligament reconstruction is considered for primary osteoarthritis or inflammatory arthropathy.

The technique described here has some potential advantages or disadvantages compared with alternative procedures. ^, No graft needs to be passed behind or completely through the sternum, which increases the safety of the procedure. In addition, the graft is placed centrally in the coronal plane, which optimizes clavicle alignment with the sternum. However, resection of the medial end of the clavicle may be perceived as a disadvantage, since it has the potential to impact the strut function of the clavicle in a negative way if shortening is excessive.