Siddiqui A A, Turner S M
Coventry and Warwickshire Hospital, Stoney Stanton Road, Coventry CV1 4FH, UK.
Injury. 2003 Jun;34(6):448-53. doi: 10.1016/s0020-1383(02)00350-9.
The sternoclavicular joint dislocates posteriorly if the costoclavicular ligaments, posterior capsule, and anterior capsule have all been disrupted. Diagnosis of a posteriorly dislocated sternoclavicular joint is difficult on clinical examination and with plain X-rays. The treatment objective is to obtain a closed reduction, and failing this an open reduction is indicated. In the intra-operative setting the evaluation of the reduction when performed through closed means can be somewhat difficult, and intra-operative plain films do not give clear answers. Ultrasound as an imaging modality for these injuries was shown to demonstrate the state of the joint in terms of reduction, more clearly than X-rays (P<0.001). It was accurately interpreted by the vast majority of orthopaedic surgeons in an investigation, and is of great value in the intra-operative setting to confirm whether a closed reduction has been successful or not. A case is reported illustrating its use.
如果肋锁韧带、后关节囊和前关节囊均已断裂，胸锁关节会向后脱位。临床上通过体格检查和普通X线片很难诊断胸锁关节后脱位。治疗目标是实现闭合复位，若无法实现则需进行切开复位。在手术过程中，通过闭合方式进行复位时，评估复位情况可能会有些困难，术中普通X线片也无法给出明确答案。超声作为这些损伤的一种成像方式，在显示关节复位状态方面比X线片更清晰（P<0.001）。在一项调查中，绝大多数骨科医生都能准确解读超声结果，并且在手术过程中，超声对于确认闭合复位是否成功具有重要价值。本文报告了一个说明其应用的病例。
