Weniger VATA Presentation 2007

Posterior Clavicle Dislocation in a Collegiate Field Hockey Player: A Case Study: 

Posterior Clavicle Dislocation in a Collegiate Field Hockey Player: A Case Study Jerry Weniger MEd, ATC, CSCS Grace Weniger MEd, ATC, PES

Background: 

Background 20 y/o female FH player Fell on right shoulder Subjective: Felt 'crunch' in shoulder Pain in right UE Inability to move right arm Objective: Posterior step-off deformity of clavicle at sterno-clavicular joint

Background: 

Background Athlete referred to ED Initial radiographs (-) Discharged with sling, instructed to treat symptomatically Advised to seek orthopedic physician evaluation if symptoms persisted Posterior step-off deformity remained evident the next day

Differential Diagnosis: 

Differential Diagnosis Clavicle fracture Sterno-clavicular joint sprain Sterno-clavicular dislocation Clavicle bone bruise Manubrium fracture

Treatment & Clinical Course: 

Treatment andamp; Clinical Course Athlete continued to have pain, ↓ mobility Received 2nd radiographs Serendipity view AP view of the clavicles with the tube angled upward by 40° in the supine position Revealed posterior dislocation of clavicle at sterno-clavicular joint

Diagnosis: 

Diagnosis Posterior Clavicle Dislocation at Sterno-clavicular Joint

Treatment & Clinical Course: 

Treatment andamp; Clinical Course Orthopedic Physician determined: Proximal end of clavicle had scarred down Joint was stable Not clinically reducible Referred to thoracic surgeon Surgical reduction not indicated Prescribed rehabilitation Regain range of motion Increase strength Regain neuromuscular control Become functional

Criteria for Return to Competition: 

Criteria for Return to Competition Regained full mobility and strength Dislocation remained stable No Sandamp;S of neurovascular or airway compromise Required to wear upper body protection

Uniqueness of Case: 

Uniqueness of Case Posterior clavicle dislocations are rare Serendipity View Returned to play without reduction Innovation of brace for protection

Conclusion: 

Conclusion Athlete continues to compete without complications or sequelae

Questions?: 

Questions?