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单皮质胸骨移植重建治疗前胸锁关节不稳定。

Unicortical sternal graft reconstruction for anterior sternoclavicular joint instability.

机构信息

Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington, USA.

Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, Texas, USA

出版信息

BMJ Case Rep. 2021 Mar 10;14(3):e237164. doi: 10.1136/bcr-2020-237164.

Abstract

Sternoclavicular joint (SCJ) injury represents 3%-5% of all shoulder girdle injuries, yet can produce significant pain and disability. While conservative management improves symptoms in most cases, surgical intervention may be indicated for patients with symptoms recalcitrant to nonoperative treatment. A wide range of surgical stabilisation techniques is documented in the literature; however, the scarcity of SCJ pathology has hindered development of a 'gold standard'.We present a minimalistic medial clavicle osteoplasty and SCJ reconstruction using semitendinosus autograft anchored with unicortical sternal tunnels in the 54 years old with chronic SCJ instability. This technique can be performed safely, resulting in joint stability and pain reduction, while avoiding risks and complications noted in the literature with other techniques.

摘要

胸锁关节 (SCJ) 损伤占所有肩带损伤的 3%-5%,但可引起明显的疼痛和残疾。虽然大多数情况下保守治疗可改善症状,但对于对非手术治疗无反应的患者,可能需要手术干预。文献中记载了多种手术稳定技术;然而,SCJ 病理的稀缺性阻碍了“金标准”的发展。我们为一位 54 岁慢性 SCJ 不稳定患者提供了一种微创的锁骨内侧骨切除术和使用半腱肌自体移植物进行的 SCJ 重建,该移植物通过单皮质胸骨隧道固定。这种技术可以安全地进行,可实现关节稳定和减轻疼痛,同时避免了文献中其他技术所注意到的风险和并发症。

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本文引用的文献

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Arthroscopic Excision of the Sternoclavicular Joint.胸锁关节的关节镜下切除术
Arthrosc Tech. 2017 Sep 25;6(5):e1697-e1702. doi: 10.1016/j.eats.2017.06.026. eCollection 2017 Oct.
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