Bilateral Sternoclavicular Joint Dislocation with Inferior Sternal Migration: Surgical Management and One-Year Outcome

Abstract

Bilateral sternoclavicular joint (SCJ) dislocation is an exceptionally rare injury, particularly when associated with inferior migration of the sternal body and multiple rib fractures. We report the case of a 51-year-old male who sustained high-energy thoracic crush trauma resulting in bilateral SCJ dislocation, inferior sternal displacement, rib fractures, and a Grade I open humeral shaft fracture. Surgical management required a multidisciplinary approach including SCJ reduction, ligament reconstruction with a semitendinosus tendon graft in a figure-of-eight configuration, clavicular fixation, and delayed intramedullary nailing of the humeral shaft. Postoperatively, neuropathy secondary to a C8-T1 brachial plexus injury was diagnosed; it was considered traumatic in origin, as no intraoperative manipulation occurred. At one-year follow-up, full functional recovery was achieved in the right upper limb, whereas residual limitation on the left side was attributable to persistent neurological involvement rather than mechanical instability. This case represents an uncommon combination of bilateral SCJ dislocation with inferior sternal migration and associated thoracic and neurological injuries, providing relevant surgical and clinical insights.