Koudela K, Koudelová J, Šimánek V
Klinika ortopedie a traumatologie pohybového ústrojí FN a LF UK Plzeň
Acta Chir Orthop Traumatol Cech. 2012;79(3):279-83.
We present the case report of a 21-year-old man with a late diagnosis of retrosternal dislocation of the sternoclavicular joint with a fractured sternal end of the clavicle. The first symptom leading to the diagnosis was dysphagia associated with physical activity. The diagnosis was based on computed tomography examination. In the first place, the fragment of the medial clavicular end was fixed with two screws. During surgery the sternoclavicular joint was wrongly identified; this fact was revealed by the following radiographic examination. On revision surgery, the sternoclaviculr ligament was reconstructed using a semitendinosus tendon graft. The reconstructed ligament was augmented with two Orthocord sutures running between the clavicle and the first rib. At 2 years after surgery the functional outcome and sternoclavicular joint stability were excellent.
我们报告一例21岁男性患者，其胸骨柄锁骨关节后脱位伴锁骨胸骨端骨折诊断较晚。导致诊断的首发症状是与体力活动相关的吞咽困难。诊断基于计算机断层扫描检查。首先，用两枚螺钉固定锁骨内侧端的骨折碎片。手术过程中错误地识别了胸骨柄锁骨关节；这一情况在随后的影像学检查中被发现。在翻修手术中，使用半腱肌腱移植重建了胸骨柄锁骨韧带。重建韧带用两根在锁骨和第一肋之间穿行的Orthocord缝线加强。术后2年，功能结果和胸骨柄锁骨关节稳定性极佳。
