Bicos James, Nicholson Gregory P
Department of Orthopedic Surgery, Rush-Presbyterian-St. Luke's Medical Center, 1650 West Harrison Street, Chicago, IL 60612, USA.
Clin Sports Med. 2003 Apr;22(2):359-70. doi: 10.1016/s0278-5919(02)00112-6.
Sternoclavicular joint injuries are uncommon. The anatomy is not familiar to most orthopaedic surgeons, and there is a high risk of both intraoperative catastrophic and postsurgical complications when performing surgery in this region. Anterior SC joint instability should primarily be treated conservatively. The patients should be informed that there is a high risk of persistent instability with nonoperative or operative care, but that the persistent instability will be well tolerated and have little functional impact in the vast majority. Therefore, operative intervention for anterior SC joint instability is mainly cosmetic in nature. Patients with posterior SC joint dislocations require an expeditious diagnosis and treatment, due to the proximity of the displaced medial clavicle to the great vessels. An early closed reduction will usually be stable. Operative stabilization must, however, be considered if the closed reduction is unsuccessful or there is persistent SC instability. SC joint stabilization should be performed with a soft tissue reconstruction, repairing both the costoclavicular ligaments and the SC capsular envelope.
胸锁关节损伤并不常见。大多数骨科医生对其解剖结构并不熟悉，并且在该区域进行手术时，术中发生灾难性并发症和术后并发症的风险都很高。胸锁关节前侧不稳定主要应采用保守治疗。应告知患者，非手术或手术治疗都有持续不稳定的高风险，但在绝大多数情况下，这种持续不稳定会被很好地耐受，且对功能影响很小。因此，胸锁关节前侧不稳定的手术干预主要是出于美容目的。胸锁关节后侧脱位的患者由于移位的锁骨内侧靠近大血管，需要迅速诊断和治疗。早期闭合复位通常会很稳定。然而，如果闭合复位不成功或存在持续的胸锁关节不稳定，则必须考虑手术稳定。胸锁关节稳定应通过软组织重建来进行，修复肋锁韧带和胸锁关节囊。
