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A. Sternoclavicular sprains and dislocations

A1. Cliniacal features

(1) ์ „๋ฐฉ ํƒˆ๊ตฌ์™€ ํ›„๋ฐฉ ํƒˆ๊ตฌ๋กœ ๋‚˜๋ˆ„์–ด์ง€๋ฉฐ ์ „๋ฐฉ์ด ํ›จ์”ฌ ๋” ํ”ํ•จ. (9:1) (2) ์ฃผ์š” ์ฆ์ƒ์€ ์‹ฌํ•œ ํ†ต์ฆ์ด๋ฉฐ, ํŒ”์„ ์›€์ง์ด๊ฑฐ๋‚˜ ๋ฐ”๋กœ ๋ˆ„์šธ ๋•Œ ์•…ํ™”๋จ. (3) ์ „๋ฐฉ ํƒˆ๊ตฌ์—์„œ์˜ ํ•ฉ๋ณ‘์ฆ์€ ๋ฏธ์šฉ์ƒ์˜ ๋ฌธ์ œ๊ฐ€ ๊ฐ€์žฅ ๋งŽ์Œ. Medial clavicle์ด ๋‘๋“œ๋Ÿฌ์ ธ ๋ณด์ž„ (4) ํ›„๋ฐฉ ํƒˆ๊ตฌ์—์„œ ํ‰๊ฐ• ๋‚ด ํ˜น์€ ์ƒ๋ถ€์ข…๊ฒฉ๋™ ๊ตฌ์กฐ๋ฌผ์˜ ์†์ƒ์„ ์ผ์œผํ‚ฌ ์ˆ˜ ์žˆ์œผ๋ฉฐ ์ฒœ๋ช…, ์—ฐํ•˜๊ณค๋ž€, ์ˆจ๊ฐ€์จ ๋“ฑ์˜ ์ฆ์ƒ์„ ๋ณด์ผ ์ˆ˜ ์žˆ์Œ.(๋ณดํ†ต ๋งŒ์ ธ์ง€์ง€ ์•Š๋Š”๋‹ค.) (5) Sternoclavicular sprain์˜ ๊ฒฝ์šฐ ice, sling, analgesics ๋“ฑ์œผ๋กœ ์น˜๋ฃŒํ•˜๋ฉฐ ๋น„์™ธ์ƒํ™˜์ž์˜ Sternoclavicular sprain์€ Septic arthritis๋ฅผ ์˜์‹ฌํ•ด ๋ด์•ผ ํ•œ๋‹ค.

A2. Diagnosis

(1) XR๋กœ๋Š” ํƒˆ๊ตฌ ๋ฐœ๊ฒฌ ๋ฏผ๊ฐ๋„๊ฐ€ ๋‚ฎ์œผ๋‚˜, ๊ธฐํ‰, ๊ธฐ์ข…๊ฒฉ๋™, ํ˜ˆํ‰ ๋“ฑ์˜ ๊ฐ๋ณ„์„ ์œ„ํ•ด ํ•„์š”ํ•จ. (2) CT ์ดฌ์˜์ด procedure of choice์ด๋ฉฐ, ํ›„๋ฐฉํƒˆ๊ตฌ ์‹œ ์ข…๊ฒฉ๋™์†์ƒ์—ฌ๋ถ€๋ฅผ ํ™•์ธํ•  ์ˆ˜ ์žˆ์Œ. (3) US : Sternoclavicular joint effusion์„ ํ™•์ธํ•  ์ˆ˜ ์žˆ์Œ.

A3. Treatment

(1) ์ „๋ฐฉ ํƒˆ๊ตฌ๋Š” clavicular splinting, ice, analgesics, sling, ๊ทธ๋ฆฌ๊ณ  OS refer ํ•„์š”. (2) ์ „๋ฐฉ ํƒˆ๊ตฌ๋Š” 10์ผ ์ด๋‚ด์˜ ์†์ƒ์˜ ๊ฒฝ์šฐ Close reduction์„ ์‹œํ–‰ํ•ด๋ณผ ์ˆ˜ ์žˆ๋‹ค. (3) ํ›„๋ฐฉ ํƒˆ๊ตฌ์˜ ๊ฒฝ์šฐ ๊ธฐํ‰, ๊ทธ๋ฆฌ๊ณ  ์ฃผ์œ„์˜ ํฐํ˜ˆ๊ด€์ด๋‚˜ trachea, ์‹๋„ ๋“ฑ์˜ ์••๋ฐ•์ด๋‚˜ ์ฐข์–ด์ง์ด ๋ฐœ์ƒํ•  ์ˆ˜ ์žˆ์–ด OS ํ˜‘์ง„ ํ›„ closed ๋˜๋Š” open reduction ์‹œํ–‰.