Van Tongel Alexander, De Wilde Lieven
Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Gent, Belgium.
Muscles Ligaments Tendons J. 2012 Feb 15;1(3):100-5. Print 2011 Jul.
Traumatic sternoclavicular (SC) joint injuries are rare. The goal of this literature review was to evaluate the available literature on the treatment of traumatic anterior and posterior SC (fracture-) dislocations in adults and children. In adults, anterior dislocations are most commonly treated by nonoperative means. Closed reduction can be attempted but is associated with a high recurrence rate. For posterior dislocations, closed reduction is usually more successful. Children usually present with displaced physeal fractures, as true dislocations probably do not occur in a skeletally immature population. Anterior displacement can easily be reduced but it is difficult, if not impossible, to maintain the reduction. In contrast with the recommendations in adults, ORIF with the use of absorbable sutures can be indicated in these cases. No consensus exists on the recurrence of posterior displacement after closed reduction. If closed reductions fails, operative treatment is indicated, using the same technique as in anterior displacement.
创伤性胸锁关节(SC)损伤较为罕见。本文献综述的目的是评估关于成人和儿童创伤性胸锁关节前后脱位(骨折-脱位)治疗的现有文献。在成人中,前脱位最常采用非手术方法治疗。可尝试闭合复位,但复发率较高。对于后脱位,闭合复位通常更成功。儿童通常表现为骨骺骨折移位,因为在骨骼未成熟人群中可能不会发生真正的脱位。前移位很容易复位,但即使不是不可能,维持复位也很困难。与成人的建议相反,在这些情况下可考虑使用可吸收缝线进行切开复位内固定(ORIF)。对于闭合复位后后移位的复发,目前尚无共识。如果闭合复位失败,则需采用与前移位相同的技术进行手术治疗。