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Mittelfristige Ergebnisse der operativen Behandlung bei Claviculaosteitis

Medium-term results of surgical treatment for osteitis of the clavicle

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Zusammenfassung

Studienziel

Die Osteitis des Schlüsselbeins ist eine Rarität. In der vorliegenden Studie werden ein stadiengerechtes Therapiekonzept sowie mittelfristige Ergebnisse einer konsekutiven Fallserie vorgestellt.

Methode

22 Patienten (12 Frauen, 10 Männer; BMI Ø24,6 kg/m2; Alter Ø 48 Jahre) wurden operativ behandelt und nach Ø13,3 (3–53) Monaten nachuntersucht. Die prä- und postoperative Diagnostik umfasste klinische Untersuchung, Labordiagnostik, Erhebung des Constant-Scores und Röntgenaufnahmen.

Ergebnisse

Bei allen Patienten konnte eine dauerhafte Infektberuhigung erreicht werden; in 6 Fällen durch ein mehrzeitiges Vorgehen. Die angrenzenden Gelenke waren bei 16 Patienten beteiligt. Die Constant-Scores verbesserten sich von prä- zu postoperativ signifikant von durchschnittlich 66 auf 84. In den 5 Fällen einer totalen Clavicularesektion zeigten sich postoperativ ebenfalls gute Werte.

Schlussfolgerung

Das beschriebene Therapiekonzept ist geeignet, bei guten funktionellen Ergebnissen eine dauerhafte Infektberuhigung zu erreichen. Häufig waren die Nachbargelenke ins Infektgeschehen einbezogen und mussten operativ saniert werden.

Abstract

Aim

Osteitis of the clavicle is rare and not well described in the international literature. We describe a concept of surgical treatment with medium-term observations.

Method

A total of 22 patients (12 women, 10 men; BMI Ø 24.6 kg/m2, age Ø 48 years) with osteitis of the clavicle were included in the series. The treatment regime consisted of a surgical approach. Data collection was prospective. Data gathered preoperatively and at follow-up included clinical examination, laboratory findings, radiographs and the Constant scoring system. The mean follow-up period was 13.3 (3–53) months.

Results

The described surgical concept was able to permanently eliminate infection in all cases studied. Surgical revisions were required in six patients. The average Constant score showed a significant increase from 66 to 84 at follow-up. Patients also showed good functional results after total resection of the clavicle.

Conclusion

The reported treatment regime provides reliable results in terms of eliminating infection with good clinical results. Neighboring joints were frequently also involved in the infection and needed to be surgically addressed.

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  1. BG-Unfallkrankenhaus Hamburg, Bergedorfer Straße 10, 21033, Hamburg, Deutschland

    R. Oheim, J. Gille, C.H. Grimme, D. Hadler, S. Wallstabe & U.J. Gerlach

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  1. R. Oheim
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  2. J. Gille
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  3. C.H. Grimme
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  4. D. Hadler
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  5. S. Wallstabe
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  6. U.J. Gerlach
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Correspondence to R. Oheim.

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Oheim, R., Gille, J., Grimme, C. et al. Mittelfristige Ergebnisse der operativen Behandlung bei Claviculaosteitis. Unfallchirurg 114, 597–603 (2011). https://doi.org/10.1007/s00113-010-1921-6

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  • DOI: https://doi.org/10.1007/s00113-010-1921-6

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