Abstract
Background
Posterior sternoclavicular dislocations are common in younger patients and are frequently due to high energy sporting incidents.
Aim
We aim to demonstrate a novel technique that is safe and aims to provide good functional post-operative outcomes for patients with this injury.
Methods
This was a single-surgeon case series of four young patients from October 2017 to July 2019. The operative technique involved relocating the joint and holding it in situ with nylon suture tape. The tape was anchored in holes drilled in the sternum and passed through tunnels drilled into the medial clavicle. All of the patients were contacted retrospectively and a Nottingham Clavicle Score (NCS) was performed for each patient on a post-operative basis.
Results
No intra-operative or post-operative complications were noted. All of the patients demonstrated a significant improvement in their functional outcomes after the operation. The average NCS for the four patients was 82/100.
Discussion
There are a variety of techniques described in the literature to repair this ligament using either plates or tendon grafts. All of these techniques describe the drilling of anteroposterior holes in the manubrium and clavicle which run the intra-operative risk of perforating a major vessel. This paper is the first one to describe a technique which uses superior inferior holes which minimizes the risks, making the procedure safer for the patient.
Conclusions
We believe this novel technique is safer than the existing described techniques, and it does not compromise on functional outcomes.
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Availability of data and material
All of the data are available on request.
Code availability
This data was analysed using Microsoft Excel.
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Appendix
Appendix
Full list of Arthrex® InternalBrace™ equipment used:
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BioComposite SwiveLock®, 3.5 mm × 15.8 mm with #2 FiberTape
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Tap for 3.5 mm SwiveLock®
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Drill guide
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Drill, cannulated, 2.7 mm
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Drill, 2.7 mm
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BioComposite SwiveLock®, 4.75 mm × 19.1 mm
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Tap for 4.75 mm SwiveLock®
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Drill, 3.4 mm
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Guide wire with trocar tip, 1.35 mm
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Free needles, qty. 2
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Suture passing wire, nitinol, 200 mm
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Keohane, D., Morrissey, D. Repair of sternoclavicular joint ligament: a novel approach. Ir J Med Sci 191, 2141–2145 (2022). https://doi.org/10.1007/s11845-021-02826-6
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DOI: https://doi.org/10.1007/s11845-021-02826-6