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一例年轻运动员罕见的复杂单纯性胸锁关节后脱位。

A rare case of complicated pure posterior sternoclavicular dislocation in a young athlete.

机构信息

Dipartimento Scienze Chirurgiche Ospedale Maggiore Parma, U.O. Clinica Ortopedica.

a) Department of Medicine and Surgery, Orthopaedic Clinic, Parma University Hospital, Via Gramsci 14,43100 Parma, Italy.

出版信息

Acta Biomed. 2020 Dec 30;91(14-S):e2020015. doi: 10.23750/abm.v91i14-S.10949.

Abstract

Sternoclavicular joint dislocation (SCJD) is a rare injury, generally classified in anterior and posterior. The posterior SCJD is very infrequent yet potentially associated with life-threatening complications. In patients with unfused medial clavicle physis, SCJD can be associated with fracture-dislocation (Salter type I or II). We hereby present the case of a 12- year-old basketball player with severe pain in sternoclavicular region and arising dysphagia after a fall and tackle by another player. A SCJ injury was hypothesised and the CT scan detected the presence of a true posterior SCJD with no associated fracture, which was also confirmed during open reduction. As the patient complained dysphagia, it was also necessary to study other possible mediastinal compressions by a contrast medium CT scan of the great vessels. The CT scanned brachiocephalic vein compression without additional clinical evidence or signs. Twenty hours after the trauma the patient underwent an unsuccessful closed reduction; for this reason, surgical treatment with open reduction and fixation was mandatory. After 12 weeks of therapy she returned to her previous sport activity.

摘要

胸锁关节脱位(SCJD)是一种罕见的损伤,通常分为前脱位和后脱位。后 SCJD 非常罕见,但可能与危及生命的并发症有关。在未融合的内侧锁骨骨骺患者中,SCJD 可伴有骨折脱位(Salter Ⅰ型或Ⅱ型)。我们在此介绍一例 12 岁篮球运动员的病例,该患者在被另一名球员摔倒和擒抱后出现严重的胸锁关节区域疼痛和吞咽困难。我们假设存在 SCJ 损伤,CT 扫描发现存在真正的后 SCJD,但无相关骨折,开放性复位时也得到了证实。由于患者诉有吞咽困难,还需要通过大血管对比剂 CT 扫描研究其他可能的纵隔压迫。CT 扫描显示头臂静脉受压,但无其他临床证据或迹象。创伤后 20 小时,患者行不成功的闭合复位;因此,需要行开放性复位和固定的手术治疗。治疗 12 周后,她恢复了之前的运动活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dbb/7944707/786da824446e/ACTA-91-15-g001.jpg

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