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, 黃富國, 陳剛, 等. 一期手法松解關節鏡下肩袖修補術治療肩袖撕裂合并凍結肩的臨床療效. 中國修復重建外科雜志, 2018, 32(1): 1-6.
7.	任江濤, 徐叢, 劉向林, 等. 關節鏡下縫線橋分層修復術治療肩袖分層撕裂的臨床研究. 中國修復重建外科雜志, 2017, 31(10): 1168-1172.
8.	曾錦源, 葉君健, 謝昀, 等. 橈骨遠端微型鎖定鋼板治療明顯移位的鎖骨內側端骨折療效分析. 中國修復重建外科雜志, 2019, 33(5): 527-530.
9.	孫遠林, 陽運康, 葛建華, 等. 新型胸鎖關節解剖鎖定鋼板的研制與臨床應用. 中國修復重建外科雜志, 2018, 32(03): 316-321.
10.	謝建偉, 周海燕, 楊君, 等. 關節腔內注射右美托咪定對老年肩關節手術后的鎮痛作用. 中國老年學雜志, 2018, 38(5): 1127-1129.
11.	蘇貴媛. 麻醉下手法松解加燙熨治療肩周炎的臨床及護理. 微創醫學, 2018, 13(6): 835-837.
12.	方凱彬, 許雙塔, 鄭煜暉, 等. 胸腔鏡輔助復位與傳統手法復位經皮髓內釘內固定治療鎖骨中段骨折的療效比較. 中國修復重建外科雜志, 2019, 33(3): 323-327.
13.	朱立帆, 曾金才, 蔣富貴, 等. 解剖鎖定板聯合聚酯縫線固定治療 NeerⅡB 型鎖骨遠端骨折. 中國修復重建外科雜志, 2017, 31(6): 760-761.
14.	湯紅偉, 殷勇, 韓擎天, 等. 解剖鎖定鋼板內固定聯合喙鎖韌帶重建治療 Neer Ⅱb 型鎖骨遠端骨折的療效研究. 中國修復重建外科雜志, 2018, 32(9): 1181-1186.
15.	黃剛, 柳海峰, 謝衛勇, 等. 關節鏡下改良彈性固定 Latarjet 術治療一例慢性鎖定性肩關節前脫位. 中國修復重建外科雜志, 2019, 33(3): 387-389.
16.	劉波, 鞠亮, 黃壽國, 等. 胸鎖鉤鋼板加胸鎖韌帶重建治療胸鎖關節前脫位12例. 中國中醫骨傷科雜志, 2018, 26(1): 61-63.
17.	孫駿, 彭張建, 戴沖華, 等. 帶線錨釘固定自體肌腱重建治療胸鎖關節慢性不穩 18 例報告. 中國骨與關節雜志, 2017, 6(9): 699-701.
18.	姚紹平, 孫先潤, 高國璽, 等. 鎖骨鉤鋼板治療胸鎖關節前脫位的近期療效. 中國矯形外科雜志, 2014, 22(20): 1899-1901.
19.	董佩龍, 唐曉波, 王健. 重建鎖定鋼板治療胸鎖關節脫位的近期療效. 中國修復重建外科雜志, 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.	楊琨, 吳天昊, 李根, 等. 胸鎖關節的解剖學及生物力學特征. 中國組織工程研究, 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.	董加純, 支中正, 顏冰珊, 等. 鋼纜內固定鎖骨近段和胸骨髓腔修復胸鎖關節脫位: 解剖與臨床. 中國組織工程研究, 2014, 18(4): 583-588.
25.	楊琨, 陽運康, 葛建華, 等. 胸鎖關節解剖鎖定鋼板的研制及生物力學研究. 中國修復重建外科雜志, 2018, 32(1): 7-13.
26.	姚學宇. 手術內固定治療胸鎖關節脫位的臨床療效分析. 杭州: 浙江大學, 2016.
27.	徐磊, 陳偉, 周敬杰, 等. 胸鎖關節松動術治療肱骨近端骨折術后患者肩關節功能障礙的效果. 臨床與病理雜志, 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, 黃富國, 陳剛, 等. 一期手法松解關節鏡下肩袖修補術治療肩袖撕裂合并凍結肩的臨床療效. 中國修復重建外科雜志, 2018, 32(1): 1-6.
7. 任江濤, 徐叢, 劉向林, 等. 關節鏡下縫線橋分層修復術治療肩袖分層撕裂的臨床研究. 中國修復重建外科雜志, 2017, 31(10): 1168-1172.
8. 曾錦源, 葉君健, 謝昀, 等. 橈骨遠端微型鎖定鋼板治療明顯移位的鎖骨內側端骨折療效分析. 中國修復重建外科雜志, 2019, 33(5): 527-530.
9. 孫遠林, 陽運康, 葛建華, 等. 新型胸鎖關節解剖鎖定鋼板的研制與臨床應用. 中國修復重建外科雜志, 2018, 32(03): 316-321.
10. 謝建偉, 周海燕, 楊君, 等. 關節腔內注射右美托咪定對老年肩關節手術后的鎮痛作用. 中國老年學雜志, 2018, 38(5): 1127-1129.
11. 蘇貴媛. 麻醉下手法松解加燙熨治療肩周炎的臨床及護理. 微創醫學, 2018, 13(6): 835-837.
12. 方凱彬, 許雙塔, 鄭煜暉, 等. 胸腔鏡輔助復位與傳統手法復位經皮髓內釘內固定治療鎖骨中段骨折的療效比較. 中國修復重建外科雜志, 2019, 33(3): 323-327.
13. 朱立帆, 曾金才, 蔣富貴, 等. 解剖鎖定板聯合聚酯縫線固定治療 NeerⅡB 型鎖骨遠端骨折. 中國修復重建外科雜志, 2017, 31(6): 760-761.
14. 湯紅偉, 殷勇, 韓擎天, 等. 解剖鎖定鋼板內固定聯合喙鎖韌帶重建治療 Neer Ⅱb 型鎖骨遠端骨折的療效研究. 中國修復重建外科雜志, 2018, 32(9): 1181-1186.
15. 黃剛, 柳海峰, 謝衛勇, 等. 關節鏡下改良彈性固定 Latarjet 術治療一例慢性鎖定性肩關節前脫位. 中國修復重建外科雜志, 2019, 33(3): 387-389.
16. 劉波, 鞠亮, 黃壽國, 等. 胸鎖鉤鋼板加胸鎖韌帶重建治療胸鎖關節前脫位12例. 中國中醫骨傷科雜志, 2018, 26(1): 61-63.
17. 孫駿, 彭張建, 戴沖華, 等. 帶線錨釘固定自體肌腱重建治療胸鎖關節慢性不穩 18 例報告. 中國骨與關節雜志, 2017, 6(9): 699-701.
18. 姚紹平, 孫先潤, 高國璽, 等. 鎖骨鉤鋼板治療胸鎖關節前脫位的近期療效. 中國矯形外科雜志, 2014, 22(20): 1899-1901.
19. 董佩龍, 唐曉波, 王健. 重建鎖定鋼板治療胸鎖關節脫位的近期療效. 中國修復重建外科雜志, 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. 楊琨, 吳天昊, 李根, 等. 胸鎖關節的解剖學及生物力學特征. 中國組織工程研究, 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. 董加純, 支中正, 顏冰珊, 等. 鋼纜內固定鎖骨近段和胸骨髓腔修復胸鎖關節脫位: 解剖與臨床. 中國組織工程研究, 2014, 18(4): 583-588.
25. 楊琨, 陽運康, 葛建華, 等. 胸鎖關節解剖鎖定鋼板的研制及生物力學研究. 中國修復重建外科雜志, 2018, 32(1): 7-13.
26. 姚學宇. 手術內固定治療胸鎖關節脫位的臨床療效分析. 杭州: 浙江大學, 2016.
27. 徐磊, 陳偉, 周敬杰, 等. 胸鎖關節松動術治療肱骨近端骨折術后患者肩關節功能障礙的效果. 臨床與病理雜志, 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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