Clavicle Dislocation: Long-Term Effects and Rehabilitation

Sternoclavicular joint dislocation

Due to a car accident, there is a partial dislocation of the right clavicle.
It has been 6 months since the accident, and the bone has not been realigned.
I have undergone physical therapy, including shortwave therapy, electrical stimulation, and laser treatment for 4 months.
Certain movements of my arm cause discomfort.
When I look in the mirror and perform movements such as rotation or raising my arm, I notice that the right clavicle has a greater range of motion.
Due to the pandemic, I have not been able to continue physical therapy.
I would like to ask the doctor if the lack of realignment of the bone will lead to any long-term complications.
The rehabilitation doctor mentioned that manual manipulation could be attempted, but it may not necessarily result in realignment.
Thank you.

Jia You, 50~59 year old female. Ask Date: 2021/05/26

Dr. Wang Shouji reply Orthopedics

Hello, a partial dislocation of the sternoclavicular joint is difficult to maintain in position even with manual reduction.
Its impact on upper limb function should be minimal.
It is advisable to focus on rehabilitation to improve shoulder joint mobility and strength training.
Changhua Hospital cares about your health.
Wang Shou-ji.

Reply Date: 2021/05/26

More Info

Clavicle dislocation, particularly when it involves a partial dislocation (or subluxation), can lead to a variety of long-term effects if not properly treated. The clavicle, or collarbone, plays a crucial role in shoulder stability and function. When it becomes dislocated, it can affect not only the bone itself but also the surrounding muscles, ligaments, and nerves.
In your case, having experienced a clavicle dislocation six months ago, it is understandable that you are concerned about the potential long-term consequences. If the bone has not returned to its normal position (reduction), there are several factors to consider regarding your recovery and rehabilitation.

Long-Term Effects of Clavicle Dislocation
1. Chronic Pain and Discomfort: One of the most common long-term effects of an untreated clavicle dislocation is chronic pain. This discomfort can stem from the altered biomechanics of the shoulder joint and surrounding structures. You mentioned experiencing discomfort during certain movements, which could be indicative of ongoing issues related to the dislocation.

2. Reduced Range of Motion: The inability to fully move your arm or shoulder can be a significant consequence of a dislocated clavicle. If the dislocation has not been addressed, you may find that certain movements, such as lifting your arm or rotating it, are limited. This can lead to compensatory movements that may further exacerbate discomfort or lead to additional injuries.

3. Muscle Weakness: Over time, if the shoulder is not used properly due to pain or limited range of motion, the muscles around the shoulder may weaken. This can lead to instability and further complications, making rehabilitation more challenging.

4. Joint Instability: If the clavicle does not heal properly, it may lead to joint instability. This can result in a higher risk of future dislocations or injuries, particularly during physical activities or sports.

5. Arthritis: In some cases, untreated dislocations can lead to early onset arthritis in the shoulder joint due to abnormal wear and tear on the joint surfaces.

Rehabilitation Considerations
Rehabilitation is crucial for recovery from a clavicle dislocation. Here are some key points to consider:
1. Physical Therapy: Continuing physical therapy is essential. Even if you have not been able to attend sessions due to the pandemic, it is important to resume therapy as soon as possible. A physical therapist can provide tailored exercises to improve strength, flexibility, and range of motion.

2. Manual Therapy: Your rehabilitation doctor mentioned that manual therapy could be attempted. This may involve specific techniques to help realign the clavicle and improve function. However, it is essential to have a qualified professional perform this to avoid further injury.

3. Home Exercises: In addition to professional therapy, you can engage in home exercises that focus on gentle stretching and strengthening of the shoulder muscles. Always consult with your therapist or doctor before starting any new exercise regimen.

4. Monitoring Symptoms: Keep track of any changes in your symptoms. If you experience increased pain, swelling, or changes in function, it is crucial to report these to your healthcare provider.

5. Surgical Options: If conservative management does not yield satisfactory results, surgical intervention may be considered. This could involve realigning the clavicle and stabilizing it with hardware, depending on the severity of the dislocation and the impact on your daily life.

Conclusion
In summary, a clavicle dislocation that has not been properly treated can lead to various long-term effects, including chronic pain, reduced range of motion, muscle weakness, joint instability, and potential arthritis. It is vital to continue rehabilitation efforts and consult with healthcare professionals to explore all available options for recovery. Engaging in a structured rehabilitation program can significantly improve your outcomes and help restore function to your shoulder.

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