Article

Resection arthroplasty of the sternoclavicular joint

Department of Orthopaedics, The University of Texas Medical School at San Antonio, 78284-7774, USA.
The Journal of Bone and Joint Surgery (Impact Factor: 4.31). 04/1997; 79(3):387-93.
Source: PubMed

ABSTRACT The results of resection of the medial end of the clavicle to treat a painful sternoclavicular joint in fifteen patients were retrospectively reviewed. The patients fell into two groups: eight patients who had had a primary arthroplasty of the sternoclavicular joint in which the costoclavicular ligament was left intact (group I), and seven patients who had had revision of a failed arthroplasty of the sternoclavicular joint and in whom the costoclavicular ligament had to be reconstructed (group II). The results for these two groups were compared at an average of 7.7 years postoperatively. All eight patients in group I had an excellent result. In sharp contrast, three patients in group II had an excellent result, three had a fair result, and one had a poor result. We conclude that preservation or reconstruction of the costoclavicular ligament is essential at the time of resection of the medial portion of the clavicle in order to obtain a satisfactory result.

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Available from: Federico Alberto Grassi, Sep 03, 2014
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    • "Many techniques of sternoclavicular stabilization have been described: soft-tissue reconstruction [5] [8] [9] [6], plate fixation [2] [34] [19] [39] [21], suture anchors [1]. Resection of the medial clavicle was described to treat chronic painful SCJ dislocation with degenerative lesions as seen in our case [36] [17]. Fixation with K-wires is not recommended because of the potential risk of migration towards vital structures [10] [3] [41] [27]. "
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    ABSTRACT: The posterior variety of sternoclavicular joint dislocation is an uncommon condition accounting for 0.06% of all shoulder injuries, the diagnosis is often missed, but frequently associated to a high morbidity by compromising the great vessels, trachea, oesophagus, or lungs. Although the majority of these complications are observed in acute presentation, few reports noted late complications with chronic unreduced dislocation. We describe a 26-year-old man, with chronic posterior sternoclavicular joint dislocation; the diagnosis was made 6 months after the injury when the dislocation was causing subclavian vein compression, treatment consisted of an excision of the medial end of the clavicle and costoclavicular stabilization with sterno-cleido-mastoid tendon. At 6 months’ follow-up, the patient felt well and had returned to work with slight restriction and intermittent use of non steroidal anti-inflammatory medication. This report shows clearly the possibility of serious complications in a chronic unreduced posterior sternoclavicular dislocation and highlights the importance to recognize and reduce at its initial presentation. The urgent CT scan is the best method for diagnosis and should be obtained when this injury is suspected.
    Injury Extra 03/2013; 44(5):46-49. DOI:10.1016/j.injury.2013.03.012
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    • ".). Among the most commonly used techniques, that of Jackson Burrows using the subclavious muscle tendon or those performing temporary joint fixation by means of internal fixation devices such as osteosutures, cerclage wirings or cannulated screws) [3] [17] [18]. "
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    ABSTRACT: Proximal physeal fracture-separation of the clavicle is a very rare injury occurring in the adolescent and in the young adult which involves a contact loss with fracture between the clavicle and its cartilaginous ossification center similar in appearance to a sternoclavicular dislocation. The authors report an unusual case of a proximal physeal fracture-separation of the clavicle with avulsion of sternoclavicular periosteal and ligamentous structures without vasculonervous injury in a 16-year-old young person. A CT scan examination is essential. Surgical management consisted in costoclavicular ligament and periosteum reattachment associated with reduction of the fracture-separation and pin fixation.This repair demonstrated a successful outcome at 8-month follow-up.
    Orthopaedics & Traumatology Surgery & Research 03/2011; 97(3):349-52. DOI:10.1016/j.otsr.2010.08.007 · 1.17 Impact Factor
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    • "In addition, the authors argued against resection of the medial clavicle, as advocated by several authors [87] [88], and presented four patients with poor results including pain and weakness of the operative extremity following medial clavicular resection [78]. It should be noted that these cases involved resection of approximately 2.5 centimeters of the medial clavicle without stabilization, which has subsequently been shown to adversely affect the results [89] [90]. Wirth and Rockwood have advocated operative intervention for an anterior SC joint dislocation only when persistent symptoms of post-traumatic arthritis are present for 6 to 12 months, and if these symptoms can be completely relieved by injection of a local anesthetic into the SC joint. "
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    ABSTRACT: Although common, AC joint injuries and their treatments are not benign. The injury itself and both nonsurgical and surgical treatments may result in complications yielding persistent pain, deformity, or dysfunction. Sternoclavicular joint injuries are far less common and are typically the result of higher energy trauma. As such, the associated complications may be more serious. Familiarity with the potential complications of these injuries can help the treating physician to develop strategies to minimize their incidence and sequelae.
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