Bony Thorax Case 2 Management
Patients will require pain control. Reduction of a SC dislocation can be attempted under procedural sedation. For a stable anterior dislocation, a towel clip can percutaneously grasp the medial clavicle to manipulate it into its correct position while simultaneously applying posterior pressure. Recurrent dislocation is common. Posterior dislocations should trigger orthopedic and thoracic surgery consultation since most are reduced in the operating room under general anesthesia due to the risk of mediastinal injury. However, if the patient presents with airway compromise or a pulseless limb, emergent reduction is indicated. This can be done by placing a shoulder roll on the affected side and pulling gentle traction on the upper extremity while it is held in abduction to 90°and slight extension.