Wang Dean, Camp Christopher L, Werner Brian C, Dines Joshua S, Altchek David W
Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
Arthrosc Tech. 2017 Oct 2;6(5):e1749-e1753. doi: 10.1016/j.eats.2017.06.046. eCollection 2017 Oct.
Dislocation of the sternoclavicular joint is a rare injury and typically requires high-energy forces applied through the joint. Initial treatment is dependent on the direction of dislocation, with acute reduction indicated for posterior dislocations presenting with signs of tracheal, esophageal, or neurovascular compression. Although most patients do well with conservative treatment after the initial trauma, some can have persistent pain and scapular dyskinesia due to instability or locked dislocation of the sternoclavicular joint. Stabilization of the sternoclavicular joint with reconstruction may be indicated for those with persistent symptoms despite a trial of steroid injections and physical therapy. In this report and video, we present a figure-of-8 reconstruction technique to reduce and stabilize a posterior dislocation of the sternoclavicular joint using a gracilis autograft. Ultimately, this reconstruction technique can be performed in a safe, efficient, and reliable manner when appropriate surgical steps are followed.
胸锁关节脱位是一种罕见的损伤,通常需要通过关节施加高能量外力。初始治疗取决于脱位方向,对于出现气管、食管或神经血管受压体征的后脱位需进行急症复位。虽然大多数患者在初始创伤后采用保守治疗效果良好,但部分患者可能因胸锁关节不稳定或锁定脱位而出现持续疼痛和肩胛运动障碍。对于那些尽管尝试了类固醇注射和物理治疗仍有持续症状的患者,可能需要采用重建手术来稳定胸锁关节。在本报告及视频中,我们展示了一种8字重建技术,使用股薄肌自体移植物来复位并稳定胸锁关节后脱位。最终,若遵循适当的手术步骤,这种重建技术能够以安全、高效且可靠的方式进行。