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patient name: Blake Foucht

age: 11

condition: posterior sternoclavicular joint dislocation

seen in: orthopedics

provider: Sarah Steward, MD, pediatric orthopedic surgeon

Blake is a super-athletic sixth grader from Kettering, Ohio. Throughout the year, you can find him playing any combination of sports, including baseball, wrestling or football.

Before one of his football practices last fall, Blake was tossing the football around with his teammates. During one exchange, he went up for the ball at the same time as his friend and the boys collided. Blake’s friend landed right on top of him and his shoulder.

Blake’s mom, Heather, was brought to the practice field by a coach, as she approached, she could hear her son’s screams. She could tell right away that he was hurt and needed to go to the emergency department.

They headed to the closest hospital where they performed a series of X-rays on Blake’s shoulder. But the X-rays didn’t reveal anything was broken. Despite the clean X-rays, Blake was still in a tremendous amount of pain. So much so, that the physician caring for him became uneasy and decided to call the Dayton Children’s Physician Connection Line to talk through Blake’s case and what else might be wrong.

On the other end of the line at Dayton Children’s was Sarah Steward, MD, pediatric orthopedic surgeon. After hearing the details of Blake’s case, Dr. Steward immediately suspected a sternoclavicular joint dislocation. She told the physician to touch Blake in the middle of the chest. Blake immediately reacted in pain. The physician took Blake for a CT scan to confirm Dr. Steward’s diagnosis.

The CT revealed that Blake had a posterior sternoclavicular joint dislocation, a relatively rare condition that involves the dislocation of the sternoclavicular joint, which is found between the sternum and clavicle. If not identified early, the dislocation can impact the heart and lungs and lead to serious complications.

Blake was immediately transferred to Dayton Children’s by ambulance and was scheduled for surgery first thing in the morning.

“I always ask myself, ‘What if the doctor hadn’t trusted her gut? What if Dr. Steward hadn’t been the one to pick up the phone that night?’” said Heather. “If Blake’s injury hadn’t been caught, it would have been very, very bad. The stars were aligned in so many ways that night. We were lucky.”

During surgery, Dr. Steward worked to get Blake’s sternoclavicular joint back in place. Most cases with this type of dislocation, the joint flips forward, where there’s a knot on the top, but for Blake it flipped backwards. Even with the added complexity, the team was able to perform the surgery with a minimally invasive approach and they kept him overnight for observation.

Two days later, Blake returned home. But he wasn’t done with Dayton Children’s quite yet. For 12 weeks, he worked weekly with the physical therapy team to regain his strength with a goal of getting back in time for his wrestling season. Despite missing the first two months of the season, he was able to not only get back on the team, but he took first in the divisional state competition and seventh in the state.

what mattered to Blake

Today, Blake is getting ready to begin his middle school football season with no restrictions in place.

“It’s such a blessing to have Dayton Children’s in our community,” said Heather. “Of course, you don’t want anything to happen to your kids, but it’s nice to have it available. They’re truly experts that know how to support and care for kids and their families.”

the unique role helping spine patients at Dayton Children's

Few children’s hospitals see as many patients with scoliosis as the orthopedic center at Dayton Children’s. Our spine nurse navigator acts as the liaison throughout a patient's spine surgery journey.

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