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Transarticular plating for acute posterior sternoclavicular joint dislocations: a valid treatment option?

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Abstract

Background

Restoration of the sternoclavicular joint after posterior dislocation is important for upper limb function. The proximity of neuro-vascular mediastinal structures makes open reduction and internal fixation (ORIF) a high-risk procedure. The ideal treatment strategy is still debated. Our aim is to review the treatment of acute posterior sternoclavicular joint dislocation with a locking compression plate.

Materials and methods

We present our experience of transarticular plating using a locking compression plate for the treatment of three consecutive patients with posterior sternoclavicular dislocation (SCD). Our primary outcome measure was objective functional outcome using DASH (disability of the arm, shoulder and hand) and PROMIS (patient-reported outcomes measurement information system) questionnaires. All patients had a minimum follow-up of six months, and serial radiographs were reviewed to evaluate maintenance of reduction.

Results

All three patients presented a posterior SCD with instability refractory to closed reduction. In all three patients, we opted for surgical management using open reduction and fixation with a locking compression plate and allowed early mobilization at two weeks postoperatively. No complications were encountered during follow-up. Good functional outcomes were evidenced by DASH scores of 7.5, 20 and 30, and PROMIS scores were 53.8, 53.8 and 38.1 in each patient, respectively.

Conclusion

Our experience of transarticular plating using a locking compression plate for posterior SCD is positive, as it allows early mobilization and resulted in good functional outcomes.

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References

  1. Wirth MA, Rockwood CA Jr (1996) Acute and chronic traumatic injuries of the sternoclavicular joint. J Am Acad Orthop Surg 4(5):268–278

    Article  PubMed  Google Scholar 

  2. Nettles JL, Linscheid RL (1968) Sternoclavicular dislocations. J Trauma 8(2):158–164

    Article  CAS  PubMed  Google Scholar 

  3. Renfree KJ, Wright TW (2003) Anatomy and biomechanics of the acromioclavicular and sternoclavicular joints. Clin Sports Med 22(2):219–237

    Article  PubMed  Google Scholar 

  4. Spencer EE et al (2002) Ligamentous restraints to anterior and posterior translation of the sternoclavicular joint. J Shoulder Elbow Surg 11(1):43–47

    Article  PubMed  Google Scholar 

  5. Mehta JC, Sachdev A, Collins JJ (1973) Retrosternal dislocation of the clavicle. Injury 5(1):79–83

    Article  CAS  PubMed  Google Scholar 

  6. Ono K et al (1998) Posterior dislocation of the sternoclavicular joint with obstruction of the innominate vein: case report. J Trauma 44(2):381–383

    Article  CAS  PubMed  Google Scholar 

  7. Jain S, Monbaliu D, Thompson JF (2002) Thoracic outlet syndrome caused by chronic retrosternal dislocation of the clavicle. Successful treatment by transaxillary resection of the first rib. J Bone Joint Surg (Br) 84(1):116–118

    Article  CAS  Google Scholar 

  8. Rayan GM (1994) Compression brachial plexopathy caused by chronic posterior dislocation of the sternoclavicular joint. J Okla State Med Assoc 87(1):7–9

    CAS  PubMed  Google Scholar 

  9. Rajaratnam S, Kerins M, Apthorp L (2002) Posterior dislocation of the sternoclavicular joint: a case report and review of the clinical anatomy of the region. Clin Anat 15(2):108–111

    Article  CAS  PubMed  Google Scholar 

  10. Deren ME et al (2014) Posterior sternoclavicular dislocations: a brief review and technique for closed management of a rare but serious injury. Orthop Rev (Pavia) 6(1):5245. doi:10.4081/or.2014.5245

    Article  PubMed Central  Google Scholar 

  11. Yeh GL, Williams GR Jr (2000) Conservative management of sternoclavicular injuries. Orthop Clin N Am 31(2):189–203

    Article  CAS  Google Scholar 

  12. Brinker MR et al (1997) A method for open reduction and internal fixation of the unstable posterior sternoclavicular joint dislocation. J Orthop Trauma 11(5):378–381

    Article  CAS  PubMed  Google Scholar 

  13. Stahel PF, Barlow B, Tepolt F et al (2013) Safe surgical technique: reconstruction of the sternoclavicular joint for posttraumatic arthritis after posterior sternoclavicular dislocation. Patient Saf Surg 7(1):38. doi:10.1186/1754-9493-7-38

  14. Worman LW, Leagus C (1967) Intrathoracic injury following retrosternal dislocation of the clavicle. J Trauma 7(3):416–423

    Article  CAS  PubMed  Google Scholar 

  15. Thut D et al (2011) Sternoclavicular joint reconstruction--a systematic review. Bull NYU Hosp Jt Dis 69(2):128–135

    PubMed  Google Scholar 

  16. Shuler FD, Pappas N (2008) Treatment of posterior sternoclavicular dislocation with locking plate osteosynthesis. Orthopedics 31(3):273

    Article  PubMed  Google Scholar 

  17. Bot SDM et al (2004) Clinimetric evaluation of shoulder disability questionnaires: a systematic review of the literature. Ann Rheum Dis 63(4):335–341. doi:10.1136/ard.2003.007724

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Rose M, Bjorner JB, Becker J et al (2008) Evaluation of a preliminary physical function item bank supported the expected advantages of the Patient-Reported Outcomes Measurement Information System (PROMIS). J Clin Epidemiol 61(1):17–33. doi:10.1016/j.jclinepi.2006.06.025

  19. McCulloch P, Henley BM, Linnau KF (2001) Radiographic clues for high-energy trauma: three cases of sternoclavicular dislocation. AJR Am J Roentgenol 176(6):1534

    Article  CAS  PubMed  Google Scholar 

  20. Koch MJ, Wells L (2012) Proximal clavicle physeal fracture with posterior displacement: diagnosis, treatment, and prevention. Orthopedics 35(1):e108–e111. doi:10.3928/01477447-20111122-39

    PubMed  Google Scholar 

  21. Aure A, Hetland KR, Rokkum M (2012) Chronic posterior sternoclavicular dislocation. J Orthop Trauma 26(4):e33–e35. doi:10.1097/BOT.0b013e318214e867

    Article  PubMed  Google Scholar 

  22. Velutini JA, Tarazona PF (1998) Fracture of the manubrium with posterior displacement of the clavicle and first rib. A case report. Int Orthop 22(4):269–271

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Burnstein MI, Pozniak MA (1990) Computed tomography with stress maneuver to demonstrate sternoclavicular joint dislocation. J Comput Assist Tomogr 14(1):159–160

    Article  CAS  PubMed  Google Scholar 

  24. Groh GI, Wirth MA (2011) Management of traumatic sternoclavicular joint injuries. J Am Acad Orthop Surg 19(1):1–7

    Article  PubMed  Google Scholar 

  25. Allman FL Jr (1967) Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am 49(4):774–784

    PubMed  Google Scholar 

  26. Franck WM et al (2003) Balser plate stabilization: an alternate therapy for traumatic sternoclavicular instability. J Shoulder Elbow Surg 12(3):276–281. doi:10.1016/S1058-2746(02)86802-1

    Article  PubMed  Google Scholar 

  27. Bontempo NA, Mazzocca AD (2010) Biomechanics and treatment of acromioclavicular and sternoclavicular joint injuries. Br J Sports Med 44(5):361–369. doi:10.1136/bjsm.2009.059295

    Article  PubMed  Google Scholar 

  28. Fery A, Sommelet J (1988) Sternoclavicular dislocations. Observations on the treatment and result of 49 cases. Int Orthop 12(3):187–195

    Article  CAS  PubMed  Google Scholar 

  29. Glass ER et al (2011) Treatment of sternoclavicular joint dislocations: a systematic review of 251 dislocations in 24 case series. J Trauma 70(5):1294–1298. doi:10.1097/TA.0b013e3182092c7b

    Article  PubMed  Google Scholar 

  30. Groh GI, Wirth MA, Rockwood CA Jr (2011) Treatment of traumatic posterior sternoclavicular dislocations. J Shoulder Elbow Surg 20(1):107–113. doi:10.1016/j.jse.2010.03.009

    Article  PubMed  Google Scholar 

  31. Tepolt F et al (2014) Posterior sternoclavicular joint injuries in the adolescent population: a meta-analysis. Am J Sports Med 42(10):2517–2524. doi:10.1177/0363546514523386

    Article  PubMed  Google Scholar 

  32. Martin SD, Altchek D, Erlanger S (1993) Atraumatic posterior dislocation of the sternoclavicular joint. A case report and literature review. Clin Orthop Relat Res 292:159–164

    PubMed  Google Scholar 

  33. Leppilahti J, Jalovaara P (1999) Migration of Kirschner wires following fixation of the clavicle—a report of 2 cases. Acta Orthop Scand 70(5):517–519

    Article  CAS  PubMed  Google Scholar 

  34. Leonard JW, Gifford RW Jr (1965) Migration of a Kirschner wire from the clavicle into the pulmonary artery. Am J Cardiol 16(4):598–600. doi:10.1016/0002-9149(65)90040-8

    Article  CAS  PubMed  Google Scholar 

  35. Janson JT, Rossouw GJ (2013) A new technique for repair of a dislocated sternoclavicular joint using a sternal tension cable system. Ann Thorac Surg 95(2):e53–e55. doi:10.1016/j.athoracsur.2012.10.047

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest in relation to the preparation of this paper.

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Authors and Affiliations

  1. Department of Orthopaedics, Denver Health Medical Centre, University of Colorado, School of Medicine, 777 Bannock Street, Denver, CO, 80204, USA

    Juan C. Quispe, Benoit Herbert, Vivek P. Chadayammuri, Jiandong Hao, Mark Hake, David J. Hak, Philip F. Stahel & Cyril Mauffrey

  2. Department of Orthopaedic Surgery, Haeundae Paik Hospital, Inje University, College of Medicine, 1435, Jwa-dong, Haeundae-gu, Busan, 612-862, Republic of Korea

    Ji Wan Kim

Authors
  1. Juan C. Quispe
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  2. Benoit Herbert
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  3. Vivek P. Chadayammuri
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  4. Ji Wan Kim
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  9. Cyril Mauffrey
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Correspondence to Cyril Mauffrey.

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Quispe, J.C., Herbert, B., Chadayammuri, V.P. et al. Transarticular plating for acute posterior sternoclavicular joint dislocations: a valid treatment option?. International Orthopaedics (SICOT) 40, 1503–1508 (2016). https://doi.org/10.1007/s00264-015-2952-y

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  • DOI: https://doi.org/10.1007/s00264-015-2952-y

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