Document Detail


Sternoclavicular joint reconstruction--a systematic review.
MedLine Citation:
PMID:  22035392     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dislocation of the sternoclavicular joint is a rare injury that has a low incidence of signifcant long-term symptoms. Surgical reconstruction of the joint is indicated in patients with symptomatic, chronic anterior instability or with irreducible or recurrent posterior instability. There have been many reported techniques for stabilization of the joint, but few investigators have reported more than several cases. The ideal reconstruction has not been identifed.
PURPOSE: The purpose of this investigation was to perform a systematic review of the available literature with the objective of identifying one technique of sternoclavicular reconstruction that could be recommended.
METHODS: A systematic review of literature pertaining to treatment of sternoclavicular joint injuries was performed, focusing on clinical reports with at least six patients and 1 year of follow-up. We also reviewed biomechanical reports pertaining to sternoclavicular reconstruction.
RESULTS: Six clinical reports and two biomechanical studies were identifed that met our inclusion criteria. Treatments described in the clinical reports included conservative treatment with a sling, repair of the joint capsule with provisional stabilization, and joint reconstruction with local tissue or graft tissue. One biomechanical study compared the strength of three reconstruction techniques.
CONCLUSION: Reconstruction with tendon tissue woven in a figure-of-eight pattern through drill holes in the manubrium and clavicle is stronger than reconstructions with local tissue. The review of clinical reports suggests excellent outcomes with this technique, and it is recommended in cases of chronic instability. In cases of acute instability requiring open reduction or inability to maintain a reduction in a posterior dislocation, there is evidence that repair of the joint capsule is suffcient surgical treatment.
Authors:
David Thut; David Hergan; Alex Dukas; Michael Day; Orrin H Sherman
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Bulletin of the NYU hospital for joint diseases     Volume:  69     ISSN:  1936-9727     ISO Abbreviation:  Bull NYU Hosp Jt Dis     Publication Date:  2011  
Date Detail:
Created Date:  2011-10-31     Completed Date:  2012-02-23     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  101300541     Medline TA:  Bull NYU Hosp Jt Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  128-35     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Biomechanical Phenomena
Dislocations / physiopathology,  surgery*
Humans
Joint Instability / physiopathology,  surgery*
Orthopedic Procedures*
Reconstructive Surgical Procedures*
Recovery of Function
Sternoclavicular Joint / physiopathology,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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