Treatment Outcomes of Anterior Sternoclavicular Joint Dislocation Using an Acromioclavicular Joint Hook Plate Versus a Locking Plate: A Retrospective Study
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Abstract Background: We aimed to compare the efficacy and functional outcomes of using an acromioclavicular joint hook plate (AJHP) versus a locking plate (LP) in the treatment of anterior sternoclavicular joint dislocation. Methods: Seventeen patients with anterior sternoclavicular joint dislocation were retrospectively analyzed from May 2014 to September 2019. Six patients were surgically treated with an AJHP, and 11 were surgically treated with an LP. Five male and one female patients composed the AJHP group, and nine male and two female patients composed the LP group. The mean age of all patients was 49.5 years. Results: Reduction and fixation were performed with AJHP or LP in all 17 patients. All patients were followed up for a mean duration of 14.4 months. There were no reported complications, wound infections, or instances of plate or screw breakage. The mean operative blood loss, operative time, and length of incision in the AJHP group were significantly better than those in the LP group. Shoulder girdle movement of the AJHP group was significantly better than that of the LP group. Conclusions: This study revealed that AJHP facilitated glenohumeral joint motion, reduced the risk of rupture of mediastinal structures, required a shorter incision, and had lesser blood loss and a shorter duration of operation compared with LP. However, some deficiencies require further improvement.Keywords:
Sternoclavicular joint
Joint stiffness
Joint dislocation
Introduction: Bipolar dislocation of the clavicle is an uncommon injury that is a simultaneous dislocation of the ipsilateral acromioclavicular joint and sternoclavicular joint. This injury is rare with fewer than fifty documented cases. Case report: We have reported the case of a forty-three-year-old bike trauma with posterior dislocation of the acromioclavicular joint and fracture of the medial part of the clavicle. Considering the young age of the patient and his requirement for high physical activity, we opted for the operative treatment. First, the patient was operated on with open reduction and stabilization of the acromioclavicular joint with 2 k. wires. So, thanks to conservative treatment at the medial fractures we had a good result. Conclusion: In light of current evidence, no important advice can be made about the treatment of bipolar clavicle fractures. We assume that the restoration of the anatomy of the acromioclavicular and sternoclavicular joints should be the aim of the treatment for this rare injury. Nevertheless, the treatment of a bipolar clavicle injury depends on different factors: injury pattern, age of the patient, daily activities, and comorbidity.
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Fractures of the medial third of the clavicle are the rarest of all clavicle fractures. We present two cases of medial clavicle fracture nonunions that were initially thought to be chronic anterior sternoclavicular dislocations and describe the entity of pseudo-dislocation of the sternoclavicular joint. Computed tomography should be performed on all patients with suspected or established injuries of the sternoclavicular region to ensure differentiation between fracture and dislocation.
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♦ Fractures and dislocations of the sternoclavicular joint are uncommon and often successfully treated non-operatively ♦ There are a number of poorly defined sclerotic, sometimes inflammatory, conditions with a predilection for the medial clavicle.
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Posterior dislocation of the clavicle at the sternoclavicular joint is rare. Nonetheless, prompt diagnosis is important because the posteriorly displaced clavicle may produce serious morbidity and even death. Symptoms are variable, depending on the structures in the superior mediastinum affected. A special simple x-ray projection (the “Heinig” projection) which has been found extremely useful in the diagnosis of sternoclavicular dislocations is described. Radiographs of posterior and anterior dislocations are compared.
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Non-traumatic pathological sternoclavicular joint dislocation due to medial end of clavicle osteomyelitis is extremely rare. This kind of rare complication should be anticipated while encountering these kinds of cases. A sixty-three-year-old male came with pain and swelling over the left neck and was diagnosed to have left clavicle osteomyelitis. The unexplored complication of sternoclavicular joint dislocation and successful management of such complications has been discussed in this case report. To best of our knowledge this is the first case report of a non-traumatic pathological sternoclavicular joint dislocation due to clavicle osteomyelitis. This case report will supplement the inadequate literature in management of such cases.
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Bipolar "floating" clavicle injuries are infrequent upper-extremity injuries that occur secondary to a high-energy trauma, which can cause dislocation at the sternoclavicular (SC) and acromioclavicular joints. Given the rarity of this injury, there is not a consensus regarding clinical management. Although anterior dislocations can be managed nonoperatively, posterior dislocations may pose a threat to chest-wall structures and typically are managed surgically. Here, we present our preferred technique for concomitant management of a locked posterior SC joint dislocation with associated grade 3 acromioclavicular joint dislocation. Reconstruction of both ends of the clavicle was performed in this case, using a figure-of-8 gracilis allograft and nonabsorbable suture reconstruction for the SC joint, and an anatomic acromioclavicular joint and coracoclavicular ligament reconstruction with semitendinosus allograft and nonabsorbable suture.
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