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Long-term outcome after joint reconstruction or medial resection arthroplasty for anterior SCJ instability

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

In the present study, the long-term results of 11 patients with anterior sternoclavicular joint (SCJ) instability are reported. All included patients had an anterior SCJ instability and due to delayed diagnosis, operative treatment was not done immediately.

Method

The patients had a mean age of 29.2 years (range 16–63 years). One patient sustained concomitant injuries. Six patients had resection arthroplasty. Five patients had reconstruction of the SCJ with transosseous tension band PDS fixation or ligament reconstruction with additional wire cerclage. The results of treatment were evaluated after a mean follow-up period of 9.9 years (range 1–27 years) using the ASES, DASH and power-, age and gender adjusted Constant–Murley Score.

Results

In general, the mean values of the different scores (ASES 79.8; DASH 11.8; Constant–Murley 81%) demonstrated good outcome. The outcome evaluation of the patients who had SCJ reconstruction did not differ significantly from the patients who had medial resection arthroplasty. The rate of postoperative pain or instability was low using visual analog scale and did not differ significantly between the groups. The outcome results of the reconstruction group were equal to the results of the resection group when SCJ-reconstruction was performed soon after SCJ injury. One patient in the resection group (6 patients) demonstrated poor results due to continued instability of the remaining clavicle.

Conclusion

We concluded that patient selection and a specific clinical indication for operative treatment are crucial. Resection of the medial clavicle results in good functional outcome when the costoclavicular ligament is preserved or reconstructed.

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References

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

    PubMed  Google Scholar 

  2. Bankart ASB (1938) An operation for recurrent dislocation (subluxation) of the sternoclavicular joint. Br J Surg 26:320–323. doi:10.1002/bjs.18002610211

    Article  Google Scholar 

  3. Barth E, Hagen R (1983) Surgical treatment of dislocations of the sternoclavicular joint. Acta Orthop Scand 54:746–747

    CAS  PubMed  Google Scholar 

  4. Bicos J, Nicholson GP (2003) Treatment and results of sternoclavicular joint injuries. Clin Sports Med 22:359–370. doi:10.1016/S0278-5919(02)00112-6

    Article  PubMed  Google Scholar 

  5. Bisson LJ, Dauphin N, Marzo JM (2003) A safe zone for resection of the medial end of the clavicle. J Shoulder Elbow Surg 12:592–594. doi:10.1016/S1058-2746(03)00176-9

    Article  PubMed  Google Scholar 

  6. Booth CM, Roper BA (1979) Chronic dislocations of the sternoclavicular joint. An operative repair. Clin Orthop Relat Res 140:17–20

    PubMed  Google Scholar 

  7. Burrows HJ (1951) Tenodesis of subclavius in the treatment of recurrent dislocation of the sterno-clavicular joint. J Bone and Joint Surg 33B(2):240–243

    CAS  Google Scholar 

  8. Brown JE (1961) Anterior sternoclavicular dislocation. A method of repair. Am J Orthop 39:184–189

    Google Scholar 

  9. Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    PubMed  Google Scholar 

  10. Cope R, Riddervold HO, Shore JL, Sistrom CL (1991) Dislocation of the sternoclavicular joint: anatomic basis, etiologies, and radiologic diagnosis. J Orthop Trauma 5:379–384. doi:10.1097/00005131-199109000-00021

    Article  CAS  PubMed  Google Scholar 

  11. DeJong KP, Sukul DM (1990) Anterior sternoclavicular dislocation. A long term follow-up study. J Orthop Trauma 4:420–423

    CAS  Google Scholar 

  12. DePalma AF (1963) Surgical anatomy of acromioclavicular and sternoclavicular joints. Surg Clin North Am 43:1541–1550

    CAS  PubMed  Google Scholar 

  13. Ernberg LA, Hollis PG (2003) Radiographic evaluation of the acromioclavicular and sternoclavicular joints. Clin Sports Med 22:255–275. doi:10.1016/S0278-5919(03)00006-1

    Article  PubMed  Google Scholar 

  14. Eskola A, Vainionpaa S, Vastamaki M, Slatis P, Rokkanen P (1989) Operation for old sternoclavicular dislocation. Results in 12 cases. J Bone Joint Surg Br 71:63–65

    CAS  PubMed  Google Scholar 

  15. Ferrera PC, Wheeling HM (2000) Sternoclavicular injuries. Am J Emerg Med 18:1–8

    Google Scholar 

  16. Franck WM, Jannasch O, Siassi M (2003) Balser plate stabilization. An alternate therapy, for traumatic sternoclavicular instability. J Shoulder Elbow Surg 12:276–281. doi:10.1016/S1058-2746(02)86802-1

    Article  PubMed  Google Scholar 

  17. Friedl W, Fritz T (1994) Polydioxanon cord fixation in sternoclavicular joint dislocation and para-articular fractures of the clavicle operation technique. Unfallchirurg 97:263–265

    CAS  PubMed  Google Scholar 

  18. Garretson RB, Williams GR (2003) Clinical evaluation of injuries to the acromioclavicular and sternoclavicular joints. Clin Sports Med 22:239–254. doi:10.1016/S0278-5919(03)00008-5

    Article  PubMed  Google Scholar 

  19. Haas N, Blauth M (1989) Injuries to the acromio- and sternoclavicular joints: surgical or conservative treatment? Orthopadie 18:234–246

    CAS  Google Scholar 

  20. Hobbs DW (1968) Sternoclavicular joint: a new axial radiographic view. Radiology 90:801

    CAS  PubMed  Google Scholar 

  21. Kälicke T, Andereya S, Westhoff J, Gekle C, Müller EJ, Muhr G (2003) Anterior sternoclavicular dislocation caused by indirect compression trauma. Eur J Trauma 29:327–330. doi:10.1007/s00068-003-1313-5

    Article  Google Scholar 

  22. Jougon JB, Lepront DJ, Dromer CE (1996) Posterior dislocation of the sternoclavicular joint leading to mediastinal compression. Ann Thorac Surg 61:711–713. doi:10.1016/0003-4975(95)00745-8

    Article  CAS  PubMed  Google Scholar 

  23. Kattan KR (1973) Modified view for use in roentgen examination of the sternoclavicular joints. Radiology 108:8

    CAS  PubMed  Google Scholar 

  24. Lunseth PA, Chapman KW, Frankel VH (1975) Surgical treatment of chronic dislocation of the sternoclavicular joint. J Bone Joint Surg Br 57-B:193–196

    Google Scholar 

  25. Martinez A, Rodriguez A, Gonzalez G, Herrera A, Domingo J (1999) Atraumatic spontaneous posterior subluxation of the sternoclavicular joint. Arch Orthop Trauma Surg 119:344–346. doi:10.1007/s004020050424

    Article  CAS  PubMed  Google Scholar 

  26. McCulloch P, Henley BM, Linnau KF (2001) Radiographic clues for high-energy trauma: three cases of sternoclavicular dislocation. AJR 176

  27. Moseley HF (1959) Athletic injuries to the shoulder region. Am J Surg 98:401–422. doi:10.1016/0002-9610(59)90534-3

    Article  CAS  PubMed  Google Scholar 

  28. Musculoskeletal Outcomes Data, Evaluation and Management System (Modems) (1997) Disability of Arm, Shoulder, Hand (DASH) Questionaire. AAOS, Rosemont/IL

  29. Nettles JL, Linscheid R (1968) Sternoclavicular dislocations. J Trauma 8:158–164. doi:10.1097/00005373-196803000-00004

    Article  CAS  PubMed  Google Scholar 

  30. Omer GE (1967) Osteotomy of the clavicle in surgical reduction of anterior sternoclavicular dislocation. J Trauma 7:584–590. doi:10.1097/00005373-196707000-00007

    Article  PubMed  Google Scholar 

  31. Perron AD (2003) Chest pain in athletes. Clin Sports Med 22:37–50. doi:10.1016/S0278-5919(02)00023-6

    Article  PubMed  Google Scholar 

  32. Renfree KJ, Wright TW (2003) Anatomy and biomechanics of the acromioclavicular and sternoclavicular joints. Clin Sports Med 22:219–237. doi:10.1016/S0278-5919(02)00104-7

    Article  PubMed  Google Scholar 

  33. Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG et al (1994) A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg 3:347–352. doi:10.1016/S1058-2746(09)80019-0

    Article  Google Scholar 

  34. Rockwood CA Jr, Groh GI, Wirth MA, Grassi FA (1997) Resection Arthroplasty of the Sternoclavicular Joint. J Bone Joint Surg Am 79:387–393

    PubMed  Google Scholar 

  35. Rockwood CA Jr, Wirth M (2003) Injuries to the sternoclavicular joint. In: Bucholz RW, Heckmand JD, Green DP et al (eds) Rockwood and Green’s fractures in adults. Saunders, Philadelphia, pp 1245–1292

    Google Scholar 

  36. Sadr B, Swann M (1979) Spontaneous dislocation of the sternoclavicular joint. Acta Orthop Scand 50:269–274

    Article  CAS  PubMed  Google Scholar 

  37. Salvatore JE (1968) Sternoclavicular joint dislocation. Clin Orthop Relat Res 58:51–55. doi:10.1097/00003086-196805000-00008

    Article  CAS  PubMed  Google Scholar 

  38. Savastano AA, Stutz SJ (1978) Traumatic sternoclavicular dislocation. Int Surg 63:10–13

    CAS  PubMed  Google Scholar 

  39. Spencer EE, Kuhn JE (2004) Biomechanical analysis of reconstructions for sternoclavicular joint instability. J Bone Joint Surg Am 86:98–105

    PubMed  Google Scholar 

  40. Toretti J, Lynch SA (2004) Sternoclavicular joint injuries. Curr Opin Orthop 15:242–247. doi:10.1097/00001433-200408000-00008

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Martin Panzica, J. Zeichen, S. Hankemeier, R. Gaulke, C. Krettek & M. Jagodzinski

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  1. Martin Panzica
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  2. J. Zeichen
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  3. S. Hankemeier
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  4. R. Gaulke
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Correspondence to Martin Panzica.

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Panzica, M., Zeichen, J., Hankemeier, S. et al. Long-term outcome after joint reconstruction or medial resection arthroplasty for anterior SCJ instability. Arch Orthop Trauma Surg 130, 657–665 (2010). https://doi.org/10.1007/s00402-009-0911-z

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