Logan Catherine, Shahien Amir, Altintas Burak, Millett Peter J
Boston Medical Center, Boston, MA, USA.
Steadman Philippon Research Institute, Vail, CO, USA.
Int J Sports Phys Ther. 2018 Aug;13(4):752-762.
Sternoclavicular (SC) joint instability is a rare injury, but one with profound implications given its proximity to vital structures and function as the only true articulation between the upper extremity and axial skeleton. The majority of SC joint instability can be treated non-operatively; however, there is a role for reconstruction in the presence of instability that results in pain and dysfunction that is refractory to conservative management or deformity resulting in functional impairment. Given the lack of inherent osseous stability at the sternoclavicular joint and the role of ligaments as primary stabilizers, surgical intervention with emphasis on ligament reconstruction may be recommended. Safe and effective rehabilitation is conducted through phase progression, with avoidance of premature stress to the healing soft tissue graft. The purpose of this clinical commentary is to provide the senior author's rehabilitation protocol, which utilizes the available scientific literature to inform phase content and progression.
胸锁关节不稳是一种罕见的损伤，但鉴于其靠近重要结构且作为上肢与中轴骨骼之间唯一真正的关节，这种损伤具有深远影响。大多数胸锁关节不稳可通过非手术治疗；然而，对于存在导致疼痛和功能障碍且保守治疗无效的不稳情况或导致功能受损的畸形时，重建手术有其作用。鉴于胸锁关节缺乏内在的骨性稳定性且韧带作为主要稳定结构，可能推荐强调韧带重建的手术干预。通过分阶段进展进行安全有效的康复，避免对愈合中的软组织移植物施加过早的应力。本临床评论的目的是提供资深作者的康复方案，该方案利用现有科学文献来指导各阶段的内容和进展。
5级。
