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Sternoclavicular dislocation: case report and surgical technique.

Terra BB, Rodrigues LM, Pádua DV, Martins MG, Teixeira JC, De Nadai A - Rev Bras Ortop (2015)

Bottom Line: Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities.This technique was shown to be safe and effective, and it allowed the patient to fully return to his sports activities.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil.

ABSTRACT
Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve rapid diagnosis and efficient treatment in order to avoid future complications. The aim of this report was to report on a case of a motocross competitor who developed chronic traumatic anterior instability of the sternoclavicular joint and underwent surgical reconstruction using the autogenous long palmar tendon. The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular subsequent to a fall during a maneuver in a motocross competition. Conservative treatment was instituted initially, consisting of use of a functional sling to treat the symptoms for 3 weeks, along with physiotherapeutic rehabilitation for 3 months. We chose to use a modification of the "figure of eight" technique based on the studies by Spencer and Kuhn. A longitudinal incision of approximately 10 cm was made at the level of the sternoclavicular joint. The graft from the ipsilateral long palmar tendon was passed through the orifices in the form of a modified "figure of eight" and its ends were sutured together. The patient was immobilized using an American sling for 4 weeks. After 6 months of follow-up, the patient no longer presented pain or instability when movement of the sternoclavicular joint was required. Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities. Thus, the patient was able to return to racing 6 months after the operation. Our study presented a case of chronic anterior dislocation of the sternoclavicular joint that was successfully treated by using a modification of the "figure of eight" reconstruction technique. This technique was shown to be safe and effective, and it allowed the patient to fully return to his sports activities.

No MeSH data available.


Related in: MedlinePlus

Image from computed tomography with 3D reconstruction (view from below), showing the displacement of the sternoclavicular joint.
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fig0025: Image from computed tomography with 3D reconstruction (view from below), showing the displacement of the sternoclavicular joint.

Mentions: The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular joint after a fall during a maneuver in a motocross championship. The trauma mechanism was a fall from a height of approximately two meters with the arm abducted and extended. Conservative treatment was used initially, with use of a functional sling for 3 weeks and treatment of the symptoms, along with physiotherapy for 3 months. However, the patient evolved with pain, discomfort and instability of the sternoclavicular joint when he raised his arm above his head, along with difficulty in swallowing when he flexed his neck anteriorly. He did not present any limitation on range of motion. During the physical examination, the anterior dislocation was visible when abduction and extension movements were made and also when the proximal end of the clavicle was manipulated (Fig. 1). Imaging examinations showed anterior dislocation of the clavicle and the presence of small periarticular bone fragments (Fig. 2, Fig. 3, Fig. 4, Fig. 5).


Sternoclavicular dislocation: case report and surgical technique.

Terra BB, Rodrigues LM, Pádua DV, Martins MG, Teixeira JC, De Nadai A - Rev Bras Ortop (2015)

Image from computed tomography with 3D reconstruction (view from below), showing the displacement of the sternoclavicular joint.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563050&req=5

fig0025: Image from computed tomography with 3D reconstruction (view from below), showing the displacement of the sternoclavicular joint.
Mentions: The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular joint after a fall during a maneuver in a motocross championship. The trauma mechanism was a fall from a height of approximately two meters with the arm abducted and extended. Conservative treatment was used initially, with use of a functional sling for 3 weeks and treatment of the symptoms, along with physiotherapy for 3 months. However, the patient evolved with pain, discomfort and instability of the sternoclavicular joint when he raised his arm above his head, along with difficulty in swallowing when he flexed his neck anteriorly. He did not present any limitation on range of motion. During the physical examination, the anterior dislocation was visible when abduction and extension movements were made and also when the proximal end of the clavicle was manipulated (Fig. 1). Imaging examinations showed anterior dislocation of the clavicle and the presence of small periarticular bone fragments (Fig. 2, Fig. 3, Fig. 4, Fig. 5).

Bottom Line: Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities.This technique was shown to be safe and effective, and it allowed the patient to fully return to his sports activities.Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Hospital Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil.

ABSTRACT
Sternoclavicular dislocations account for less than 5% of all dislocations of the scapular belt. Most cases of anterior dislocation of the sternoclavicular joint do not present symptoms. However, some patients may develop chronic anterior instability and remain symptomatic, and surgical treatment is indicated in these cases. There is a scarcity of reports in the literature relating to reconstruction using the long palmar tendon in cases of traumatic anterior instability. Although rare, these injuries deserve rapid diagnosis and efficient treatment in order to avoid future complications. The aim of this report was to report on a case of a motocross competitor who developed chronic traumatic anterior instability of the sternoclavicular joint and underwent surgical reconstruction using the autogenous long palmar tendon. The patient was a 33-year-old man with a history of anterior dislocation of the sternoclavicular subsequent to a fall during a maneuver in a motocross competition. Conservative treatment was instituted initially, consisting of use of a functional sling to treat the symptoms for 3 weeks, along with physiotherapeutic rehabilitation for 3 months. We chose to use a modification of the "figure of eight" technique based on the studies by Spencer and Kuhn. A longitudinal incision of approximately 10 cm was made at the level of the sternoclavicular joint. The graft from the ipsilateral long palmar tendon was passed through the orifices in the form of a modified "figure of eight" and its ends were sutured together. The patient was immobilized using an American sling for 4 weeks. After 6 months of follow-up, the patient no longer presented pain or instability when movement of the sternoclavicular joint was required. Minor discomfort and slight prominence of the sternoclavicular joint continued to be present but did not affect the patient's activities. Thus, the patient was able to return to racing 6 months after the operation. Our study presented a case of chronic anterior dislocation of the sternoclavicular joint that was successfully treated by using a modification of the "figure of eight" reconstruction technique. This technique was shown to be safe and effective, and it allowed the patient to fully return to his sports activities.

No MeSH data available.


Related in: MedlinePlus