Opoku-Agyeman Jude, Perez Sergio, Behnam Amir, Matera David
Department of Plastic and Reconstructive Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA.
Department of Plastic and Reconstructive Surgery, Department of Surgery, The Reading Hospital, Tower Health System, PA, USA.
J Surg Case Rep. 2019 Apr 24;2019(4):rjz122. doi: 10.1093/jscr/rjz122. eCollection 2019 Apr.
Sternoclavicular joint infection is very rare. Osteomyelitis is a known complication of septic sternoclavicular joint. Once this condition is diagnosed, aggressive management including antibiotic and surgical debridement is warranted. Patients are often left with sizeable sternoclavicular defects that may need surgical reconstruction. In this report, we describe the use of a completely detached pectoralis major flap for the reconstruction of a large sternoclavicular defect after resection for osteomyelitis. Briefly, after the debridement of the infected sternoclavicular joint, the pectoralis major was detached from its sternoclavicular attachments and further detached from the humeral attachments rendering it completely detached on a vascular pedicle. The muscle was advanced to cover the defect and secured. Patient recovered well without any surgery related complication. She retained good use of the ipsilateral upper extremity. The pectoralis major can be completely detached to provide ample coverage for sternoclavicular joint reconstruction if needed.
胸锁关节感染非常罕见。骨髓炎是化脓性胸锁关节已知的并发症。一旦诊断出这种情况，就需要积极的治疗，包括使用抗生素和手术清创。患者通常会留下较大的胸锁关节缺损，可能需要进行手术重建。在本报告中，我们描述了使用完全游离的胸大肌皮瓣重建因骨髓炎切除术后的大型胸锁关节缺损。简要地说，在对感染的胸锁关节进行清创后，将胸大肌从其胸锁附着处游离，再从肱骨附着处进一步游离，使其在血管蒂上完全游离。将肌肉推进以覆盖缺损并固定。患者恢复良好，没有任何与手术相关的并发症。她同侧上肢的功能保留良好。如果需要，胸大肌可以完全游离，为胸锁关节重建提供充足的覆盖。
