Clinical Snapshot
Movement-Induced Throat Irritation in Sternoclavicular Dislocation
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A 52-year-old man presented to the emergency department after tripping and falling on the left shoulder. Clinically, mild livid discoloration was visible on the left arm with prolonged recapillarization time in the capillary nail refill test. There was pain on palpation of the clavicle and an urge to cough upon movement of the arm. There was also a blood pressure difference between the arms (left, 109/64 mm Hg, right, 136/78 mm Hg). Contrast-enhanced computed tomography showed dislocation of the left clavicle in the sternoclavicular joint in a dorsal direction with displacement between the aorta, supraaortic arteries, and trachea as well as a mediastinal hematoma. The circulatory disorder and the urge to cough were explained by compression caused by the dislocated clavicle. Open reduction and stabilization of the sternoclavicular joint was performed in the trauma surgery department with vascular surgical support on standby. Suspicions regarding dissection of the supra-aortic arteries were not borne out. The patient was discharged free of symptoms. This case of what is generally a very rare posterior sternoclavicular dislocation demonstrates that adequate imaging should be performed prior to reduction of sternoclavicular dislocation.
Dr. med. Cornelius Sebastian Fischer, Prof. Dr. med. Tina Histing, BG Unfallklinik Tübingen, Klinik für Unfall- und Wiederherstellungschirurgie, Eberhard Karls Universität Tübingen, Germany cfischer@bgu-tuebingen.de
Dr. med. Gabriel Keller, Diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Germany
Conflict of interest statement: The authors declare that no conflict of interest exists.
Translated from the original German by Christine Rye.
Cite this as: Fischer CS, Histing T, Keller G: Movement-induced throat irritation in sternoclavicular dislocation. Dtsch Arztebl Int 2024; 121: 753. DOI: 10.3238/arztebl.m2024.0103
