Expectant Management of a Posteriorly Displaced Medial Clavicular Physeal Fracture in an Adolescent

Introduction: Sternoclavicular joint (SCJ) disruptions are rare, with posterior dislocations even less common. In pediatric patients, these injuries primarily manifest as medial clavicular physeal fractures. Posteriorly displaced SCJ injuries are of particular concern due to their potential involvement with mediastinal structures. Treatment options remain variable, with open or closed reduction favored in acute cases and conservative management considered in delayed presentations. Case Report: We present an 11-year-old male with a posteriorly displaced medial clavicular physeal fracture following a basketball injury managed nonoperatively. Long-term follow-up with computed tomography over the course of a year demonstrated good callus formation and eventual fracture healing. Despite the concerns with his posteriorly displaced SCJ injury, the patient returned to full athletic participation with no complications. Conclusion: This case supports expectant management as a viable option for medial clavicular physeal fractures with posterior displacement, particularly in delayed presentations without mediastinal involvement. Long-term follow-up demonstrated successful remodeling and return to sport without complications. Given the healing potential of the pediatric medial clavicular epiphysis, further studies are needed to investigate the viability of expectant management. Keywords: Sternoclavicular joint injury, medial clavicular physeal fracture, posterior sternoclavicular joint displacement, pediatric shoulder injury, conservative management.