SternoClavicular Dislocation, revisited

This reflection goes back to July 11 2009, the date of my crash in the bicycle race Vuelta d'Acadian,

which resulted in this rare 'sterno-clavicular' dislocation.

One would think with all the advanced technology in medicine, a diagnosis of this would have been fairly easy. Yet, in spite of clear visible signs of misalignment of the clavicle at the sternum, both X-ray and CT scan labeled it as a severe contusion, without dislocation. It was almost like I was imagining the dislocation and wanted to find proof one way or the other. Visits to several orthopedics confirmed the clinical dislocation, but could not confirm this on the scan. It was then we elected to do a MRI, which finally confirmed the first suspicion.

At this time we are 6 weeks post injury.

Hind sight equals 20/20

Yes of course I should have taken off from work at least two weeks,

and surely I never should have mounted a bike during this stretch,

not to mention, my left arm should have been in a sling, 24/7 during this time.

But what if one is still 10 feet tall and bullet proof???

________________________

So here I am, near 4 months post injury.

By now I had hoped for the formation of a lot of adhesions/scar tissue of the ruptured joint capsule,

resulting in a 'pseudo sternoclavicular joint' in this new location,(superior/anterior).

By virtue of insufficient rehabilitation, where immobilization of the traumatized joint in the acute and sub-acute stage is crucial, I now have to do with a hyper mobile sternoclavicular joint.

So far this has resulted in ongoing pain, thought the level of pain most often is not high enough to stop me from doing most anything.

I also continue to experience diffuse brachial plexus paresthesias/ tingling and numbness down into my fingers.

Herein lies the greatest danger!

It is only after accumulated activities, that I pay the price.

Having knowledge and having treated patients for over 25 years,

is of no help once one has to practice, what one has been preaching!!!

It seems I am making slow progress.

The more I realize my limitations before I engage in certain activities, the better off I am.

The alternative

Surgical reconstruction of the sternoclavicular joint seems pretty risky due to the proximity of the vascular structures.

Furthermore the outcome of a resection of the clavicle followed by securing it via tendon grafts to the sternum, does not give a guarantee of improvement and the level of success can only be determent after a lengthy rehabilitation. We are talking at least 8 to 12 weeks! No work, no cycling.....

Needless to say, this is not an option for me!!

LUCTOR ET EMERGO