Martetschläger F, Imhoff A B
Abteilung und Poliklinik für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Deutschland,
Oper Orthop Traumatol. 2014 Jun;26(3):218-27. doi: 10.1007/s00064-013-0275-y. Epub 2014 Jun 14.
Restoration of joint stability and unimpaired, painless shoulder function
Chronic and recurrent painful instabilities of the sternoclavicular (SC) joint. Locked posterior instability.
A lack of autologous tendon grafts due to harvesting of all hamstring grafts during prior surgical procedures and general contraindications for surgery/anesthesia.
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.
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.
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.
恢复关节稳定性以及实现无痛、功能正常的肩部功能
胸锁关节慢性复发性疼痛性不稳定。后方锁定性不稳定。
由于之前手术已取用所有腘绳肌移植物而导致自体肌腱移植物缺乏，以及手术/麻醉的一般禁忌症。
使用异体股薄肌腱通过胸骨和锁骨内侧的两个钻孔，采用8字形构型来恢复关节稳定性。
用吊带固定6周，进行被动活动锻炼，随后6周进行无负重主动活动。12周后，逐渐增加负重进行持续的再活动。
采用8字形构型的自体肌腱移植物进行胸锁关节重建可显著改善肩部功能并缓解疼痛。然而，可能会出现一些肩部功能损害或持续不适，术前必须与患者讨论这些情况。
