Treatment of traumatic anterior dislocation of sternoclavicular joint with allogeneic tendon of “W” type knit_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Guozhong , CHEN Shoubo , LIN Sanfu ,  WANG Wenhuai

Department of Orthopedics, the Second Affiliated Hospital of Fujian Medical University, Quanzhou Fujian, 362000, P.R.China;

Corresponding author：

WANG Wenhuai, Email: xiaodi50a@163.com

Keywords：

Anterior dislocation of sternoclavicular joint; allogeneic tendon; knitting and stitching technique; ligament repair

DOI：

10.7507/1002-1892.201902008

Video：

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Objective To investigate effectiveness of allogeneic tendon of " W” type knit in repair of traumatic anterior dislocation of sternoclavicular joint.Methods Between June 2013 and June 2017, 12 patients with traumatic anterior dislocation of sternoclavicular joint after poor conservative treatment were treated with allogeneic tendon of " W” type knit. Of them, 10 were males and 2 were females, aged from 25 to 58 years (mean, 42 years). All injuries were caused by traffic accidents. The time from injury to operation was 4-12 weeks (median, 6 weeks). All of them were closed injuries. The patients had no fracture around the shoulder, or blood vessels, nerves, and other adjacent limb joint injuries. The operation time, intraoperative blood loss, incision healing, and complications were recorded. The sternoclavicular joint was observed by X-ray film and CT at 1 year after operation. Visual analogue scale (VAS) score, University of California Los Angeles (UCLA) score, Rockwood score, modified Hospital for Special Surgery (HSS) score, and Constant-Murley score were used to evaluate the function of shoulder joint after operation.Results The operation time was 60-80 minutes (mean, 70 minutes). The intraoperative blood loss was 50-100 mL (mean, 60 mL). Primary healing of incision was obtained in all patients without complications. All the patients were followed up 12-24 months (mean, 18 months). At 1 year after operation, X-ray film and CT examination showed that the position of sternoclavicular joint was satisfactory. At 1 year after operation, the Rockwood score was 12-14 (mean, 13). The UCLA score was 28-34 (mean, 31). The VAS score was significant lower than that before operation (P<0.05), and the Constant-Murley score and modified HSS score were significantly higher than those before operation (P<0.05).Conclusion The repair of traumatic anterior dislocationr of sternoclavicula joint with allogeneic tendon of " W” type knit can effectively reconstruct the stability of the joint, retain the physiological fretting, and obtain satisfactory results.

Citation： WU Guozhong, CHEN Shoubo, LIN Sanfu, WANG Wenhuai. Treatment of traumatic anterior dislocation of sternoclavicular joint with allogeneic tendon of “W” type knit. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(8): 976-980. doi: 10.7507/1002-1892.201902008 Copy

1.	Tytherleigh-Strong G, Pecheva M, Titchener A. Treatment of first-time traumatic anterior dislocation of the sternoclavicular joint with surgical repair of the anterior capsule augmented with internal bracing. Orthop J Sports Med, 2018, 6(7). DOI: 10.1177/2325967118783717.
2.	Kawaguchi K, Tanaka S, Yoshitomi H, et al. Double figure-of-eight reconstruction technique for chronic anterior sternoclavicular joint dislocation. Knee Surg Sports Traumatol Arthrosc, 2015, 23(5): 1559-1562.
3.	Bak K, Fogh K. Reconstruction of the chronic anterior unstable sternoclavicular joint using a tendon autograft: medium-term to long-term follow-up results. J Shoulder Elbow Surg, 2014, 23(2): 245-250.
4.	Guan JJ, Wolf BR. Reconstruction for anterior sternoclavicular joint dislocation and instability. J Shoulder Elbow Surg, 2013, 22(6): 775-781.
5.	Buckley MB, Clark KR. Forensic age estimation using the medial clavicular epiphysis: A study review. Radiol Technol, 2017, 88(5): 482-498.
6.	唐新, 黄富国, 陈刚, 等. 一期手法松解关节镜下肩袖修补术治疗肩袖撕裂合并冻结肩的临床疗效. 中国修复重建外科杂志, 2018, 32(1): 1-6.
7.	任江涛, 徐丛, 刘向林, 等. 关节镜下缝线桥分层修复术治疗肩袖分层撕裂的临床研究. 中国修复重建外科杂志, 2017, 31(10): 1168-1172.
8.	曾锦源, 叶君健, 谢昀, 等. 桡骨远端微型锁定钢板治疗明显移位的锁骨内侧端骨折疗效分析. 中国修复重建外科杂志, 2019, 33(5): 527-530.
9.	孙远林, 阳运康, 葛建华, 等. 新型胸锁关节解剖锁定钢板的研制与临床应用. 中国修复重建外科杂志, 2018, 32(03): 316-321.
10.	谢建伟, 周海燕, 杨君, 等. 关节腔内注射右美托咪定对老年肩关节手术后的镇痛作用. 中国老年学杂志, 2018, 38(5): 1127-1129.
11.	苏贵媛. 麻醉下手法松解加烫熨治疗肩周炎的临床及护理. 微创医学, 2018, 13(6): 835-837.
12.	方凯彬, 许双塔, 郑煜晖, 等. 胸腔镜辅助复位与传统手法复位经皮髓内钉内固定治疗锁骨中段骨折的疗效比较. 中国修复重建外科杂志, 2019, 33(3): 323-327.
13.	朱立帆, 曾金才, 蒋富贵, 等. 解剖锁定板联合聚酯缝线固定治疗 NeerⅡB 型锁骨远端骨折. 中国修复重建外科杂志, 2017, 31(6): 760-761.
14.	汤红伟, 殷勇, 韩擎天, 等. 解剖锁定钢板内固定联合喙锁韧带重建治疗 Neer Ⅱb 型锁骨远端骨折的疗效研究. 中国修复重建外科杂志, 2018, 32(9): 1181-1186.
15.	黄刚, 柳海峰, 谢卫勇, 等. 关节镜下改良弹性固定 Latarjet 术治疗一例慢性锁定性肩关节前脱位. 中国修复重建外科杂志, 2019, 33(3): 387-389.
16.	刘波, 鞠亮, 黄寿国, 等. 胸锁钩钢板加胸锁韧带重建治疗胸锁关节前脱位12例. 中国中医骨伤科杂志, 2018, 26(1): 61-63.
17.	孙骏, 彭张建, 戴冲华, 等. 带线锚钉固定自体肌腱重建治疗胸锁关节慢性不稳 18 例报告. 中国骨与关节杂志, 2017, 6(9): 699-701.
18.	姚绍平, 孙先润, 高国玺, 等. 锁骨钩钢板治疗胸锁关节前脱位的近期疗效. 中国矫形外科杂志, 2014, 22(20): 1899-1901.
19.	董佩龙, 唐晓波, 王健. 重建锁定钢板治疗胸锁关节脱位的近期疗效. 中国修复重建外科杂志, 2013, 27(12): 1450-1452.
20.	Kirby JC, Edwards E, Kamali Moaveni A. Management and functional outcomes following sternoclavicular joint dislocation. Injury, 2015, 46(10): 1906-1913.
21.	Unterkofler J, Merschin D, Langenbach A, et al. Injuries of the sternoclavicular joint-An innovative approach in the management of a rare injury: tight rope fixation of the costo-clavicular ligament. Chirurgia (Bucur), 2017, 112(5): 611-618.
22.	杨琨, 吴天昊, 李根, 等. 胸锁关节的解剖学及生物力学特征. 中国组织工程研究, 2018, 22(11): 1695-1700.
23.	Morell DJ, Thyagarajan DS. Sternoclavicular joint dislocation and its management: A review of the literature. World J Orthop, 2016, 7(4): 244-250.
24.	董加纯, 支中正, 颜冰珊, 等. 钢缆内固定锁骨近段和胸骨髓腔修复胸锁关节脱位: 解剖与临床. 中国组织工程研究, 2014, 18(4): 583-588.
25.	杨琨, 阳运康, 葛建华, 等. 胸锁关节解剖锁定钢板的研制及生物力学研究. 中国修复重建外科杂志, 2018, 32(1): 7-13.
26.	姚学宇. 手术内固定治疗胸锁关节脱位的临床疗效分析. 杭州: 浙江大学, 2016.
27.	徐磊, 陈伟, 周敬杰, 等. 胸锁关节松动术治疗肱骨近端骨折术后患者肩关节功能障碍的效果. 临床与病理杂志, 2017, 37(5): 895-900.

1. Tytherleigh-Strong G, Pecheva M, Titchener A. Treatment of first-time traumatic anterior dislocation of the sternoclavicular joint with surgical repair of the anterior capsule augmented with internal bracing. Orthop J Sports Med, 2018, 6(7). DOI: 10.1177/2325967118783717.
2. Kawaguchi K, Tanaka S, Yoshitomi H, et al. Double figure-of-eight reconstruction technique for chronic anterior sternoclavicular joint dislocation. Knee Surg Sports Traumatol Arthrosc, 2015, 23(5): 1559-1562.
3. Bak K, Fogh K. Reconstruction of the chronic anterior unstable sternoclavicular joint using a tendon autograft: medium-term to long-term follow-up results. J Shoulder Elbow Surg, 2014, 23(2): 245-250.
4. Guan JJ, Wolf BR. Reconstruction for anterior sternoclavicular joint dislocation and instability. J Shoulder Elbow Surg, 2013, 22(6): 775-781.
5. Buckley MB, Clark KR. Forensic age estimation using the medial clavicular epiphysis: A study review. Radiol Technol, 2017, 88(5): 482-498.
6. 唐新, 黄富国, 陈刚, 等. 一期手法松解关节镜下肩袖修补术治疗肩袖撕裂合并冻结肩的临床疗效. 中国修复重建外科杂志, 2018, 32(1): 1-6.
7. 任江涛, 徐丛, 刘向林, 等. 关节镜下缝线桥分层修复术治疗肩袖分层撕裂的临床研究. 中国修复重建外科杂志, 2017, 31(10): 1168-1172.
8. 曾锦源, 叶君健, 谢昀, 等. 桡骨远端微型锁定钢板治疗明显移位的锁骨内侧端骨折疗效分析. 中国修复重建外科杂志, 2019, 33(5): 527-530.
9. 孙远林, 阳运康, 葛建华, 等. 新型胸锁关节解剖锁定钢板的研制与临床应用. 中国修复重建外科杂志, 2018, 32(03): 316-321.
10. 谢建伟, 周海燕, 杨君, 等. 关节腔内注射右美托咪定对老年肩关节手术后的镇痛作用. 中国老年学杂志, 2018, 38(5): 1127-1129.
11. 苏贵媛. 麻醉下手法松解加烫熨治疗肩周炎的临床及护理. 微创医学, 2018, 13(6): 835-837.
12. 方凯彬, 许双塔, 郑煜晖, 等. 胸腔镜辅助复位与传统手法复位经皮髓内钉内固定治疗锁骨中段骨折的疗效比较. 中国修复重建外科杂志, 2019, 33(3): 323-327.
13. 朱立帆, 曾金才, 蒋富贵, 等. 解剖锁定板联合聚酯缝线固定治疗 NeerⅡB 型锁骨远端骨折. 中国修复重建外科杂志, 2017, 31(6): 760-761.
14. 汤红伟, 殷勇, 韩擎天, 等. 解剖锁定钢板内固定联合喙锁韧带重建治疗 Neer Ⅱb 型锁骨远端骨折的疗效研究. 中国修复重建外科杂志, 2018, 32(9): 1181-1186.
15. 黄刚, 柳海峰, 谢卫勇, 等. 关节镜下改良弹性固定 Latarjet 术治疗一例慢性锁定性肩关节前脱位. 中国修复重建外科杂志, 2019, 33(3): 387-389.
16. 刘波, 鞠亮, 黄寿国, 等. 胸锁钩钢板加胸锁韧带重建治疗胸锁关节前脱位12例. 中国中医骨伤科杂志, 2018, 26(1): 61-63.
17. 孙骏, 彭张建, 戴冲华, 等. 带线锚钉固定自体肌腱重建治疗胸锁关节慢性不稳 18 例报告. 中国骨与关节杂志, 2017, 6(9): 699-701.
18. 姚绍平, 孙先润, 高国玺, 等. 锁骨钩钢板治疗胸锁关节前脱位的近期疗效. 中国矫形外科杂志, 2014, 22(20): 1899-1901.
19. 董佩龙, 唐晓波, 王健. 重建锁定钢板治疗胸锁关节脱位的近期疗效. 中国修复重建外科杂志, 2013, 27(12): 1450-1452.
20. Kirby JC, Edwards E, Kamali Moaveni A. Management and functional outcomes following sternoclavicular joint dislocation. Injury, 2015, 46(10): 1906-1913.
21. Unterkofler J, Merschin D, Langenbach A, et al. Injuries of the sternoclavicular joint-An innovative approach in the management of a rare injury: tight rope fixation of the costo-clavicular ligament. Chirurgia (Bucur), 2017, 112(5): 611-618.
22. 杨琨, 吴天昊, 李根, 等. 胸锁关节的解剖学及生物力学特征. 中国组织工程研究, 2018, 22(11): 1695-1700.
23. Morell DJ, Thyagarajan DS. Sternoclavicular joint dislocation and its management: A review of the literature. World J Orthop, 2016, 7(4): 244-250.
24. 董加纯, 支中正, 颜冰珊, 等. 钢缆内固定锁骨近段和胸骨髓腔修复胸锁关节脱位: 解剖与临床. 中国组织工程研究, 2014, 18(4): 583-588.
25. 杨琨, 阳运康, 葛建华, 等. 胸锁关节解剖锁定钢板的研制及生物力学研究. 中国修复重建外科杂志, 2018, 32(1): 7-13.
26. 姚学宇. 手术内固定治疗胸锁关节脱位的临床疗效分析. 杭州: 浙江大学, 2016.
27. 徐磊, 陈伟, 周敬杰, 等. 胸锁关节松动术治疗肱骨近端骨折术后患者肩关节功能障碍的效果. 临床与病理杂志, 2017, 37(5): 895-900.

Chinese Journal of Reparative and Reconstructive Surgery

Treatment of traumatic anterior dislocation of sternoclavicular joint with allogeneic tendon of “W” type knit

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