Granick M S, Ramasastry S S, Goodman M A, Hardesty R
University of Pittsburgh Affiliated Plastic Surgery Program, Pa.
Plast Reconstr Surg. 1989 Jul;84(1):80-4. doi: 10.1097/00006534-198907000-00015.
Osteomyelitis of the clavicle is an uncommon disease, but it should be considered in patients who present with pain, cellulitis, or drainage in the sternoclavicular area following head and neck surgery, irradiation, subclavian vein catheterization, or immunosuppression. An idiopathic presentation is possible. In contrast to primary osteomyelitis of the clavicle, which is occasionally seen in children, secondary osteomyelitis is quite rare. It is often mistaken for a fracture or a possible neoplasm on plain x-rays. Tomograms and CT scanning are confirmatory, and in early cases, technetium-99m bone scanning can be helpful. Treatment must include early, aggressive surgical debridement of all affected tissues, followed by wound coverage with a well-vascularized flap and perioperative antibiotics.
锁骨骨髓炎是一种罕见疾病，但对于在头颈部手术、放疗、锁骨下静脉插管或免疫抑制后出现胸锁关节区域疼痛、蜂窝织炎或引流的患者应予以考虑。也可能出现特发性表现。与偶尔在儿童中见到的原发性锁骨骨髓炎不同，继发性骨髓炎相当罕见。在普通X线片上，它常被误诊为骨折或可能的肿瘤。断层扫描和CT扫描可确诊，在早期病例中，锝-99m骨扫描可能有帮助。治疗必须包括早期对所有受影响组织进行积极的手术清创，随后用血运丰富的皮瓣覆盖伤口并使用围手术期抗生素。
