Skip to main content

Advertisement

SpringerLink
Log in

Surgical Technique: Results of Stabilization of Sternoclavicular Joint Luxations Using a Polydioxanone Envelope Plasty

  • Surgical Technique
  • Published:
Clinical Orthopaedics and Related Research®

A CORR Insights® to this article was published on 09 April 2013

Abstract

Background

Surgical treatment options for sternoclavicular joint luxations described in the literature are numerous, although all have limitations. Therefore, there is no favorable surgical treatment for sternoclavicular luxations when nonoperative treatment has failed.

Description of Technique

We developed the polydioxanone (PDS) envelope plasty, a modification of the figure-of-eight technique, using a PDS ligament.

Methods

We retrospectively reviewed 39 patients (40 joints), treated with a PDS envelope plasty for invalidating sternoclavicular luxations. The minimum followup was 10 months (average, 52 months; range, 10–171 months). The Simple Shoulder Test (SST), Constant-Murley shoulder score, and subjective categorical results were recorded preoperatively and postoperatively.

Results

In most patients, postoperative functional shoulder scores were excellent (mean Constant-Murley score, 90, range, 52–100; mean SST, 10; range, 2–12). Ninety percent of patients had an improvement of shoulder function at followup. Only minor complications occurred. Thirteen percent of patients had spontaneous postoperative subluxations. However, the postoperative shoulder function improved in all these patients.

Conclusions

The PDS envelope plasty is a simple procedure, a modification of the best-reported technique. We have promising results with high shoulder scores.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2A–D
Fig. 3

Similar content being viewed by others

References

  1. Abiddin Z, Sinopidis C, Grocock CJ, Yin Q, Frostick SP. Suture anchors for treatment of sternoclavicular joint instability. J Shoulder Elbow Surg. 2006;15:315–318.

    Article  PubMed  CAS  Google Scholar 

  2. Acus RW 3rd, Bell RH, Fisher DL. Proximal clavicle excision: an analysis of results. J Shoulder Elbow Surg. 1995;4:182–187.

    Article  PubMed  Google Scholar 

  3. Armstrong AL, Dias JJ. Reconstruction for instability of the sternoclavicular joint using the tendon of the sternocleidomastoid muscle. J Bone Joint Surg Br. 2008;90:610–613.

    PubMed  CAS  Google Scholar 

  4. Bae DS, Kocher MS, Waters PM, Micheli LM, Griffey M, Dichtel L. Chronic recurrent anterior sternoclavicular joint instability: results of surgical management. J Pediatr Orthop. 2006;26:71–74.

    Article  PubMed  Google Scholar 

  5. Cave EF. Shoulder girdle injuries. In Cave EF, ed. Fractures and Other Injuries. Chicago, IL: Year Book Publishers; 1958:258–259.

    Google Scholar 

  6. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160–164.

    PubMed  Google Scholar 

  7. de Jong KP, Sukul DM. Anterior sternoclavicular dislocation: a long-term follow-up study. J Orthop Trauma. 1990;4:420–423.

    PubMed  Google Scholar 

  8. Dürselen L, Dauner M, Hierlemann H, Planck H, Claes LE, Ignatius A. Resorbable polymer fibers for ligament augmentation. J Biomed Mater Res. 2001;58:666–672.

    Article  PubMed  Google Scholar 

  9. Féry A, Sommelet J. Dislocation of the sternoclavicular joint. Int Orthop. 1988;12:187–195.

    Article  PubMed  Google Scholar 

  10. Franck WM, Jannasch O, Siassi M, Hennig HF. Basler plate stabilization: an alternate therapy for traumatic sternoclavicular instability. J Shoulder Elbow Surg. 2003;12:276–281.

    Article  PubMed  Google Scholar 

  11. Gerlach D, Wemhoner SR, Ogbuihi S. [2 cases of pericardial tamponade caused by migration of fracture wires from the sternoclavicular joint] [in German]. Z Rechtsmed. 1984;93:53–60.

    Article  PubMed  CAS  Google Scholar 

  12. Glass ER, Thompson JD, Cole PA, Gause TM, Altman GT. Treatment of sternoclavicular joint dislocations: a systematic review of 251 dislocations in 24 case series. J Trauma. 2011;70:1294–1298.

    Article  PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  14. Hessmann M, Gotzen L, Gehling H, Rüschenpöhler D. [Results of reconstruction of acromioclavicular joint rupture with PDS implants] [in German]. Unfallchirurg. 1997;100:193–197.

    Article  PubMed  CAS  Google Scholar 

  15. Jaggard MK, Gupte CM, Gulati V, Reilly P. A comprehensive review of trauma and disruption to the sternoclavicular joint with the proposal of a new classification system. J Trauma. 2009;66:576–584.

    Article  PubMed  Google Scholar 

  16. Martinez A, Rodriguez A, Gonzales G, Herrera A, Domingo J. Atraumatic spontaneous posterior subluxation of the sternoclavicular joint. Arch Orthop Trauma Surg 1999;119:344–346.

    Article  PubMed  CAS  Google Scholar 

  17. Panzica M, Zeichen J, Hankemeier S, Gaulke R, Krettek C, Jagodzinski M. Long-term outcome after joint reconstruction or medial resection arthroplasty for anterior SCJ instability. Arch Orthop Trauma Surg. 2010;130:657–665.

    Article  PubMed  Google Scholar 

  18. Rockwood C, Groh GI, Wirth MA, Grassi FA. Resection arthroplasty of the sternoclavicular joint. J Bone Joint Surg Am. 1997;79:387–393.

    PubMed  Google Scholar 

  19. Rockwood CA, Odor JR. Spontaneous atraumatic subluxation of the sternoclavicular joint. J Bone Joint Surg Am. 1989;71:1280–1288.

    PubMed  Google Scholar 

  20. Salvatore JE. Sternoclavicular joint dislocation. Clin Orthop Relat Res 1968;58:51–55.

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  Google Scholar 

  22. Tashjian RZ, Deloach J, Green A, Porucznik CA, Powell AP. Minimal clinically important differences in ASES and simple shoulder test scores after nonoperative treatment of rotator cuff disease. J Bone Joint Surg Am. 2010;92:296–303.

    Article  PubMed  Google Scholar 

  23. Thomas DP, Williams PR, Hoddinott HC. A “safe” surgical technique for stabilization of the sternoclavicular joint: a cadaveric and clinical study. Ann R Coll Surg Engl. 2000;82:432–435.

    PubMed  CAS  Google Scholar 

  24. Thut D, Hergan D, Dukas A, Day M, Sherman OH. Sternoclavicular joint reconstruction: a systematic review. Bull NYU Hosp Jt Dis. 2011;69:128–135.

    PubMed  Google Scholar 

  25. van Kampen DA, van Beers LW, Scholtes VA, Terwee CB, Willems WJ. Validation of the Dutch version of the Simple Shoulder Test. J Shoulder Elbow Surg. 2012;21:808–814.

    Article  PubMed  Google Scholar 

  26. Venissac N, Alifano M, Dahan M, Mouroux J. Intrathoracic migration of Kirschner pins. Ann Thorac Surg. 2000;69:1953–1955.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, 667, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands

    Jean W. M. Gardeniers MD, PhD, Jan Burgemeester MD, Jaap Luttjeboer MD & Wim H. C. Rijnen MD, PhD

Authors
  1. Jean W. M. Gardeniers MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jan Burgemeester MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jaap Luttjeboer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wim H. C. Rijnen MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean W. M. Gardeniers MD, PhD.

Additional information

The institution of the authors has received, during the study period, funding from Stryker Benelux, (Koeweistraat 8, 4180 BA Waardenburg, Netherlands).

All Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.

Each author certifies that his or her institution approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

About this article

Cite this article

Gardeniers, J.W.M., Burgemeester, J., Luttjeboer, J. et al. Surgical Technique: Results of Stabilization of Sternoclavicular Joint Luxations Using a Polydioxanone Envelope Plasty. Clin Orthop Relat Res 471, 2225–2230 (2013). https://doi.org/10.1007/s11999-013-2890-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-013-2890-1

Keywords

Search

Navigation