Due to the proximity of the sternoclavicular joint to vulnerable structures in the superior mediastinum, dislocations must be reduced as early as possible [
20]. Forty to fifty percent of all posterior sternoclavicular joint dislocations are successfully managed by closed reduction [
21,
22]. The most frequently described reduction maneuver consists of an ‘abduction/traction’-technique with the patient placed in supine position with a bump or sandbag between the shoulders, and gradual traction applied to the abducted arm, with slow progression to extension [
23]. If the reduction maneuver is successful, the clavicle reduces with an audible ‘popping’ sound. Some authors recommend the use of a percutaneous sterile towel clip to grasp the medial clavicle with lateral and anterior traction [
23]. About 50% of all closed reduction attempts are unsuccessful and place the patient at risk of additional harm [
24]. Severe complications have been reported after closed reduction maneuvers. As an example, a “near miss” complication has been described in which the medial clavicle perforated the right pulmonary artery, and surgical exploration revealed that acute bleeding was prevented by the clavicle compressing the artery [
25]. In this circumstance, a closed reduction maneuver would have likely resulted in unforeseen disaster. Thus, multiple authors recommend the early open surgical treatment of posterior sternoclavicular dislocations [
26‐
29]. The ‘classic’ operative technique described by Burrows in 1951 consists of a subclavius tenodesis for stabilization of the sternoclavicular joint [
30]. Multiple additional surgical techniques have more recently been described, including fixation with cannulated screws [
28], bridge plating [
31,
32], cable fixation [
33], artificial ligament reconstruction [
34], and tendon reconstruction of the disrupted capsular/ligamentous complex [
35,
36]. Of note, the use of Kirschner wires has been abandoned due to the risk of pin migration resulting in delayed penetration of vascular structures [
37,
38]. Interpositional arthroplasty utilizing the sternal head of the sternocleidomastoid muscle has been recommended in conjunction with resection of the medial clavicle [
39]. Resection of the medial clavicle alone, however, has been associated with poor outcomes, particularly in cases with residual ligamentous instability [
40‐
42].