Sternoclavicular Joint
The sternoclavicular joint (articulatio sternoclavicularis) performs a crucial biomechanical function: it is the only point of connection between the free upper extremity and the trunk.
Three main structures participate in forming this joint:
- Sternal end of the clavicle;
- Clavicular notch located on the manubrium of the sternum;
- Cartilage of the 1st rib (specifically the cartilaginous part, not the body of the rib).
The joint capsule is loose and attaches strictly along the margins of the articulating surfaces. A distinctive feature of this articulation is the presence of an articular disc within the cavity. It completely divides the joint cavity into two independent chambers, classifying the joint as complex.
Biomechanics
According to the shape of its articular surfaces and range of motion, it is a multi-axial joint (moving around three axes). The following movements are possible:
- Elevation and depression of the clavicle;
- Protraction (forward movement) and retraction (backward movement) of the clavicle;
- Rotation of the clavicle along its longitudinal axis.
Ligamentous Apparatus of the Sternoclavicular Joint
The loose joint capsule is securely reinforced by a robust complex of ligaments that limit excessive mobility and protect the joint from dislocation:
- Anterior and posterior sternoclavicular ligaments (lig. sternoclaviculare anterius et posterius) — blend into the capsule from their respective sides;
- Interclavicular ligament (lig. interclaviculare) — spans between the medial ends of the right and left clavicles, passing over the manubrium of the sternum;
- Costoclavicular ligament (lig. costoclaviculare) — a powerful band anchoring the clavicle to the cartilage of the 1st rib.
Acromioclavicular Joint
The acromioclavicular joint (articulatio acromioclavicularis) is the articulation between the scapula and the clavicle.
The articular surfaces are formed by the acromion of the scapula and the lateral end of the clavicle. Unlike the sternoclavicular joint, the capsule here is thin, although it attaches similarly along the margins of the articular surfaces. An articular disc may occasionally be found within the cavity of this joint, but its presence is inconstant.
Functions and Ligaments
The range of motion in this joint is small, but it is critically important for ensuring coordinated rotation of the scapula together with the clavicle during arm elevation.
The joint is supported by the following ligamentous apparatus:
- Acromioclavicular ligament (lig. acromioclaviculare) — reinforces the capsule superiorly.
- Coracoclavicular ligament (lig. coracoclaviculare) — acts as the most vital stabilizer of the joint. It consists of two anatomical parts: the trapezoid ligament (lig. trapezoideum) and the conoid ligament (lig. conicum).