Kusnezov Nicholas, Dunn John C, DeLong Jeffrey M, Waterman Brian R
*Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center, El Paso, TX; and †Medical University of South Carolina, Charleston, SC.
J Orthop Trauma. 2016 Apr;30(4):e111-7. doi: 10.1097/BOT.0000000000000483.
To determine the functional outcomes in young, active individuals after sternoclavicular (SC) joint reconstruction.
Level IV, case series.
United States military hospitals, 2008-2012.
PATIENTS/PARTICIPANTS: Retrospective review of all consecutive patients from the Military Health System Management Analysis and Reporting Tool was performed. Patients who underwent other open-shoulder procedures (eg, acromioclavicular joint reconstruction), those of nonmilitary or retired status, and patients with under 12-month minimum follow-up without medical separation were excluded from further analysis.
Open reconstruction of SC joint dislocation.
Primary outcomes of interest were clinical failure and medical separation due to persistent shoulder girdle dysfunction. Demographic data, surgical technique, outcomes, complications, and occupational military outcomes were recorded.
Fourteen patients, with an average age of 26 years, experienced 8 anterior (57.1%) and 6 posterior (42.9%) SC joint dislocations. Four patients (28.6%) presented with dysphagia or dyspnea, and 10 patients (71.4%) had a missed diagnosis with an average of 13 months until diagnosis. Twelve of 14 (85.7%) patients underwent figure-of-eight tendon reconstruction, and 10 (71.4%) were able to return to full active military duty at an average 26.8 ± 12.9 months follow-up. There were 6 complications in 5 patients (35.7%), whereas 2 (14.3%) reported persistent instability and 2 (14.3%) required reoperation.
SC joint dislocations are rare injuries that are frequently missed on clinical presentation in this study. However, acute or delayed surgical reconstruction may afford predictable rates of return to function in young active military service members.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
确定年轻、活跃个体在胸锁关节（SC）重建后的功能结局。
IV级，病例系列。
美国军事医院，2008年至2012年。
患者/参与者：对军事卫生系统管理分析与报告工具中所有连续患者进行回顾性研究。接受过其他开放性肩部手术（如肩锁关节重建）的患者、非现役或已退役的患者，以及随访时间不足12个月且未因医疗原因退役的患者被排除在进一步分析之外。
胸锁关节脱位的开放性重建。
主要关注的结局是因持续的肩带功能障碍导致的临床失败和医疗退役。记录人口统计学数据、手术技术、结局、并发症和军事职业结局。
14例患者，平均年龄26岁，经历了8例前脱位（57.1%）和6例后脱位（42.9%）。4例患者（28.6%）出现吞咽困难或呼吸困难，10例患者（71.4%）漏诊，平均诊断延迟13个月。14例患者中有12例（85.7%）接受了8字肌腱重建，10例（71.4%）患者在平均26.8±12.9个月的随访后能够恢复全职军事任务。5例患者（35.7%）出现6例并发症，2例（14.3%）报告持续不稳定，2例（14.3%）需要再次手术。
胸锁关节脱位是罕见损伤，在本研究中临床表现时常被漏诊。然而，急性或延迟手术重建可能使年轻现役军人恢复功能的比例具有可预测性。
治疗性IV级。有关证据水平的完整描述，请参阅作者须知。
