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Sternoclavicular Joint

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  • Joint created by articulation of Sternum and Clavicle
  • Diarthrodial, saddle-type synovial joint
  • Inherently unstable due to poor osseus articulation
  • Less than 50% of the medial clavicle articulates with the corresponding manubrium
  • Ligaments
  • Costoclavicular Ligament (sometimes referred to as rhomboid ligament)
  • Anterior fasiculus: resists superior rotation and lateral displacement
  • Posterior fasiculus: resists inferior rotation and medial displacement
  • Interclavicular ligament
  • Sternoclavicular ligaments
  • Anteriot and Posterior
  • Capsular Ligaments
  • Anterior and Posterior
  • Strongest ligamentous stabilizers[1]
  • Fibrocartilagenous disc
  • Attached to the anterior and posterior SC ligaments and capsule
  • Divides SJC into two synovium-lined cavities
  • Degenerates over time and by age 70-80 is incomplete[2]
  • Subclavius Muscle
  • arises from the first rib just lateral to the costoclavicular ligament and inserts onto the inferior surface of the clavicle.
  • It is believed to have a protective function with regards to the stability of the SCJ by reducing the rate of upward displacement of the clavicle when it is under lateral compressive loads
  • Stability from intrinsic and extrinsic ligamentous structures[3]
  • Only bony articulation between axial skeleton, upper extremity[4]
  • Clavicle is first bone to ossify in utero, last to fuse occuring between ages 23-25[5] This can make distinguishing physeal injuries from sternoclavicular dislocations challenging.

Biomechanics

  • All shoulder girdle movement results in some degree of movement at the SCJ
  • Every 10° of shoulder flexion results in 4° elevation of the clavicle[6]
  • Shoulder retraction: SCJ translates anteriorly
  • Shoulder protraction: SCJ translates posteriorly
  • Subsequently, clavicle can rotate up to 40° in long axis


Origin


Insertion


Actions


Artery


Nerve


Clinical Significance


See Also


  1. Spencer EE, Kuhn JE, Huston LJ, Carpenter JE, Hughes RE. Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. J Shoulder Elbow Surg. 2002;11:43–47.
  2. van Tongel A, MacDonald P, Leiter J, Pouliart N, Peeler J. A cadaveric study of the structural anatomy of the sternoclavicular joint. Clin Anat. 2012;25:903–910.
  3. Sewell MD, Al-Hadithy N, Le Leu A, Lambert SM. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes. Bone Joint J. 2013;95-B:721–731.
  4. Spencer EE, Kuhn JE, Huston LJ, Carpenter JE, Hughes RE. Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. J Shoulder Elbow Surg. 2002;11:43–47.
  5. Wirth MA, Rockwood CA. Acute and Chronic Traumatic Injuries of the Sternoclavicular Joint. J Am Acad Orthop Surg. 1996;4:268–278.
  6. Inman VT, Saunders JB, Abbott LC. Observations of the function of the shoulder joint. 1944. Clin Orthop Relat Res. 1996;(330):3–12.
Created by:
John Kiel on 2 January 2020 15:49:47
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Last edited:
2 January 2020 16:00:42
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