Closed reduction for posterior sternoclavicular dislocation

Technique for closed reduction of the SC joint.
(A) The patient is positioned supine with a sandbag placed between the two shoulders. Traction is then applied to the arm against countertraction in an abducted and slightly extended position. In anterior dislocations, direct pressure over the medial end of the clavicle may reduce the joint.
(B) In addition to the traction, it may be necessary to manipulate the medial end of the clavicle with the fingers to dislodge the clavicle from behind the manubrium.
(C) In stubborn posterior dislocations, it may be necessary to sterilely prepare the medial end of the clavicle and use a towel clip to grasp around the medial clavicle to lift it back into position.