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A sternoclavicular sprain occurs when trauma moves the breastbone and collarbone far enough apart to damage the connecting ligaments. In mild sprains, the damage to the ligaments is minor. Acute strains, however, can result when the ligaments are torn or disconnected from the bone. Sternoclavicular injuries are fairly rare, with car accidents and sports-related injuries being the most common causes.
The most common symptom of a sternoclavicular sprain is mild to moderate pain in the center of the chest that occurs shortly after a trauma to the joint. A pronounced lump at the injury site might indicated a moderate-to-severe strain or possibly a dislocation of the clavicle bone. In very rare cases, a trauma might be serious enough to push the clavicle behind the sternum. This type of injury, called a posterior dislocation, is potentially life-threatening and might require immediate corrective surgery.
Most frequently, a minor sternoclavicular sprain will be diagnosed by a combination of physical exam and X-ray results. Patients who present with considerable pain or swelling might need further tests to determine the extent of ligament damage and completely eliminate the possibility of dislocation. These tests might include a computerized tomography (CT) scan or magnetic resonance imaging (MRI).
Patients who have been diagnosed with a mild sternoclavicular sprain are generally prescribed a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen. This medication should help treat both swelling and pain. In addition, placing an ice pack on the joint for 10-15 minutes at a time can bring further relief. Commonly, it is necessary to immobilize the shoulder by using a sling as well. The average recuperation time for a mild strain is three to seven days.
A more serious sternoclavicular sprain might stress the ligaments to such an extent that the joint becomes insecure. In these instances, a sling generally will not provide enough support to prevent further injury. A special medical support, called a figure 8 harness, might be ordered. These strains are usually treated with NSAIDs as well, but additional painkillers might also be prescribed. These types of injuries can take as long as eight weeks to heal and might require physical therapy as part of aftercare.
If a sternoclavicular dislocation can be repaired by physical manipulation, the rest of treatment is much the same as a serious sprain. Patients who require surgery can expect as long as 12 weeks for healing of the joint and can require additional surgeries to further correct the damage. Physical therapy is almost always prescribed for these individuals.
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