Sternoclavicular / Medial Clavicle Injury

Description

This is an injury to the inner end of the collarbone, where it meets the breastbone (the sternoclavicular joint). In children and teens, it is usually a growth-plate injury of the collarbone rather than a true joint dislocation, because that growth plate is the last in the body to finish.

How it happens (the mechanism)

A force to the shoulder is transmitted to the inner collarbone. Because the growth plate there does not finish until the early twenties, what looks like a sternoclavicular “dislocation” in a young person is usually a fracture through that growth plate — which actually heals and remodels better than a true joint injury. The key distinction is direction: a backward-displaced injury sits near the windpipe and great vessels and is the one evaluated urgently.

What matters

Most of these heal well. The situation to identify is the inner collarbone pushed backward (behind the breastbone), because important structures sit just behind it — so knowing which direction the bone moved guides how urgently it is treated.

Symptoms

Pain and swelling where the collarbone meets the breastbone; with backward displacement there may be trouble swallowing or breathing, which is an emergency.

Doctor examination and imaging

The doctor examines the inner collarbone; a CT scan is often used to show the direction and degree of displacement.

Treatment

An injury where the bone is in front, or only mildly displaced, is usually treated with a sling and time. A backward-displaced injury needs prompt evaluation and occasionally a procedure to bring it forward.

Recovery and long-term outlook

Most heal well, helped by the strong remodeling of this last-to-close growth plate.

When to call the doctor

Seek emergency care for any trouble breathing or swallowing, or for severe pain with a backward-displaced inner collarbone. Otherwise call for worsening pain, swelling, or fever.

Learn more

OrthoInfo (AAOS) — Growth Plate Fractures: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.