[Surgical stabilization of acute/chronic sternoclavicular instability with autologous gracilis tendon graft].

SURGICAL OBJECTIVE

Restoration of joint stability and unimpaired, painless shoulder function

INDICATIONS

Chronic and recurrent painful instabilities of the sternoclavicular (SC) joint. Locked posterior instability.

CONTRAINDICATIONS

A lack of autologous tendon grafts due to harvesting of all hamstring grafts during prior surgical procedures and general contraindications for surgery/anesthesia.

SURGICAL TECHNIQUE

Joint stability is restored by a gracilis tendon allograft passed through two drill holes in the sternum and the medial clavicle using a figure-of-eight configuration.

POSTOPERATIVE MANAGEMENT

Immobilization in a sling for 6 weeks with passive motion exercises followed by 6 weeks of active mobilization without weight-bearing. After 12 weeks, continuous remobilization with increasing weight-bearing.

RESULTS

SC joint reconstruction using an autologous tendon graft in a figure-of-eight configuration can significantly improve shoulder function and pain relief. However, some impairment of shoulder function or persistent complaints may occur, which must be discussed with the patient in the preoperative setting.