Hand-Upper Limb & Microsurgery Department, Hospital "KAT", Athens, Greece.
Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, Greece.
Injury. 2022 Apr;53(4):1562-1567. doi: 10.1016/j.injury.2021.10.022. Epub 2021 Oct 27.
Anterior sternoclavicular joint dislocation (SCJ) is a relative rare injury, related to high energy trauma. The objective of the present study is to present a novel suture technique for treatment of anterior SCJ traumatic dislocation and to report clinical outcomes from a small case series undergoing this procedure.
Patients presenting with traumatic anterior SCJ disruption in our institution were eligible to participate. Surgical technique consisted of two bone tunnels drilled in vertical direction from the anterior to the posterior cortex of the manubrium. Analogous to the sternal side of the clavicle, two vertical bone tunnels were drilled from the anterior cortex towards the posterior cortex. A non-absorbable suture was passed though the four holes in a parallel configuration. Then, by pulling the free suture edges the posterior translation of the clavicle was performed. Two additional drill holes, the first in manubrium and the second in clavicle were performed from the anterior cortex to the posterior between the previous bone tunnels. A non-absorbable suture was placed in a simple configuration in order to stabilize the SCJ in the superior-inferior direction. The final follow up was 28.2 months. The mean QuickDASH was used for functional assessment.
Seven patients (6 males and 1 female) with average age of 34,8 years were included in the present study. Two patients suffered from concomitant medial clavicle fracture. At final follow-up (none of the patients had experienced any symptoms of instability of SCJ, no side-to-side difference was observed, while the Mean QuickDASH score was 4.85.
The reported technique for SCJ reconstruction in traumatic anterior SCJ dislocations with two sutures has theoretical advantages, since it stabilizes the SCJ in the antero-posterior, as well as the supero- inferior direction. Outcomes from this small case series are favorable. However, more research is desirable to compare different techniques and to conclude to the optimal surgical treatment.
前胸锁关节（SCJ）脱位是一种相对罕见的损伤，与高能创伤有关。本研究的目的是介绍一种治疗前 SCJ 创伤性脱位的新型缝合技术，并报告接受该手术的小病例系列的临床结果。
在我们的机构中，出现创伤性前 SCJ 破裂的患者有资格参加。手术技术包括从前到后皮质在胸骨柄上钻两个垂直方向的骨隧道。类似于锁骨胸骨侧，从前皮质向后皮质钻两个垂直骨隧道。一根不可吸收缝线从前到后平行穿过四个孔。然后，通过拉动游离缝线边缘，锁骨向后移位。在前皮质到后皮质之间从前到后在胸骨柄和锁骨上进行另外两个钻孔，在先前的骨隧道之间。一根不可吸收缝线以简单的方式放置以稳定 SCJ 在上下方向。最终随访时间为 28.2 个月。平均 QuickDASH 用于功能评估。
本研究共纳入 7 例患者（6 名男性和 1 名女性），平均年龄为 34.8 岁。2 例患者伴有内侧锁骨骨折。最终随访时（无患者出现 SCJ 不稳定症状，未观察到侧到侧差异，而平均 QuickDASH 评分为 4.85。
报告的用于治疗创伤性前 SCJ 脱位的两缝线 SCJ 重建技术具有理论优势，因为它稳定了 SCJ 的前后和上下方向。来自这个小病例系列的结果是有利的。然而，需要更多的研究来比较不同的技术，并得出最佳的手术治疗结论。
