A comprehensive review of trauma and disruption to the sternoclavicular joint with the proposal of a new classification system.

Background: The sternoclavicular joint (SCJ) is rarely injured but should not be overlooked in cases of high-energy trauma. Stability is reliant on the ligamentous attachments. The methods of injury and the clinical presentations are examined. Obtaining informative plain radiology of the SCJ is challenging and the best methods to achieve this are discussed.

Methods: The Pubmed and Medline databases were searched for all literature relating to the keywords of "sternoclavicular" or "SCJ."

Conclusions: Early closed reduction in acute injury is advisable. Complications of posterior dislocation to the SCJ are potentially severe and occasionally life threatening. Long-term stability is often difficult to achieve and can be significantly debilitating. Operative methods to restore joint stability are examined and the evidence to support them is presented. We propose a simple classification system to aid in making management decisions.