Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.
J Shoulder Elbow Surg. 2013 Jan;22(1):64-9. doi: 10.1016/j.jse.2012.02.009. Epub 2012 May 18.
Dislocations of the sternoclavicular joint are rare injuries caused by massive forces applied to the joint. A high rate of complications has been reported following this injury emphasizing the importance of an accurate diagnosis and therapy.
We report a series of patients with chronic anterior or posterior sternoclavicular instability treated with figure-of-eight gracilis- or semitendinosus-tendon reconstruction. Tendon grafts were collected from the patient's ipsilateral knee. Preoperative and postoperative DASH scores were compared to evaluate the outcome.
Six patients (mean age, 22 years; range 15-46; male = 3; female = 3) were included. The patients sustained an isolated dislocation of the sternoclavicular joint resulting from a high-energy trauma. Anterior instability was observed in 3 patients, posterior instability in 2 patients and the remaining patient showed multidirectional instability. The mean time from injury to operation was 8 months (range, 4-33). The semitendinosus tendon was used in 4 patients, the gracilis tendon in 2 patients, respectively. Follow-up examination was after 22 months (range, 14-34). The DASH score improved from 54.3 points (range, 45.7-68.8) preoperatively to 28.8 points (range, 25.8-34.5) postoperatively. All patients returned to full activity without limitations including competitive contact sports.
Stabilization of the sternoclavicular joint with the figure-of-eight technique seems to be a feasible alternative for young and active patients with remaining instability following conservative treatment.
胸锁关节脱位是由关节受到巨大外力引起的罕见损伤。这种损伤后并发症发生率较高，这强调了准确诊断和治疗的重要性。
我们报告了一系列慢性前或后胸锁关节不稳定的患者，这些患者采用 8 字形股薄肌或半腱肌腱重建治疗。肌腱移植物取自患者同侧膝关节。比较术前和术后 DASH 评分，以评估结果。
共纳入 6 名患者（平均年龄 22 岁；年龄范围 15-46 岁；男性=3；女性=3）。患者因高能量创伤导致单纯性胸锁关节脱位。3 例患者存在前向不稳定，2 例患者存在后向不稳定，1 例患者表现为多向不稳定。从受伤到手术的平均时间为 8 个月（范围 4-33）。4 例患者使用半腱肌腱，2 例患者使用股薄肌腱。随访检查时间为术后 22 个月（范围 14-34）。DASH 评分从术前的 54.3 分（范围 45.7-68.8）改善至术后的 28.8 分（范围 25.8-34.5）。所有患者均恢复至完全活动状态，无限制，包括竞技接触性运动。
对于保守治疗后仍存在不稳定的年轻和活跃患者，采用 8 字形技术稳定胸锁关节似乎是一种可行的选择。
