Introduction: Infections of the sternoclavicular joint (SCJ) account for less than 1% of all joint infections. There are no standardized diagnostic and therapeutic algorithms defined in literature. This study intended to report the risk factors, the bacterial spectrum, the extent and localization and the clinical outcome of SCJ infections. Patients and methods: We retrospectively reviewed the medical charts of 13 patients (8 men, five women, mean age 37.6 years) with SCJ infections between Januray 1st 2008 and October 30th 2015 for clinical parameters and radiological studies. All patients were interviewed during their follow-up along with clinical examination and assessing the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Results: Nine patients presented with local chest pain and swelling; in 4 patients, the prevalent symptom was pain without local signs of inflammation. Full blood count revealed a mean leukocytosis of 15 Â 10 9 L and a mean CRP of 21.0 mg/dl. Approximately 61.5% reported known diabetes mellitus. 10 patients presented an involvement of surrounding structures. All patients received a preoperativ CT scan. Each patient was treated via SCJ resection without intraoperative complications. Primary wound closure was possible in all cases. The mean follow-up was 95 days. Wound culture revealed Staphylococcus aureus in all patients. Pathological examination affirmed acute osteomyelitis in 7 patients. Four patients required the intensive care of which 2 patients died from septic shock. Recurrent infection was encountered in 3 patients who underwent revision surgery. Mean DASH Score was 18.7. Conclusion: CT should be routinely obtained to recognize the possible extends to the surrounding structures. SCJ resection can result in satisfactory clinical results and should be considered in cases of extended infections including the surrounding structures. Empiric antibiotic coverage should contain cephalosporin or extended-spectrum penicillin. Inappropriate or less-invasive surgical procedures may cause recurrencent infections, especially in cases of osteomyelitis.

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Gesunde Beschäftigte, deren Muskel-Skelett-System vor Beschwerden und Erkrankungen geschützt werden soll (Primärprävention). Beschäftigte mit MSB oder MSE, die vor einer Verschlimmerung bzw. Manifestierung einer Erkrankung bewahrt werden sollen bzw. die eine Teilhabe an beruflichen Tätigkeiten wiedererlangen sollen. o Versorgungsbereich (s. DELBI-Kriterium 3) Der Versorgungsbereich ist die arbeits-und betriebsmedizinische Beratung und Vorsorge sowie die ergonomische Arbeitsgestaltung zum Erhalt der Arbeitsfähigkeit, die Vermeidung von Manifestation und Verschlimmerung arbeitsbedingter Muskel-Skelett-Erkrankungen und -Beschwerden sowie die berufliche Wiedereingliederung. o Anwenderzielgruppe/Adressaten (s. DELBI-Kriterium 6) Die Leitlinie richtet sich an Betriebsärztinnen und Betriebsärzte, Arbeitsmedizinerinnen und Arbeitsmediziner, Ergonominnen und Ergonomen, Fachkräfte für Arbeitssicherheit, Arbeitgeberinnen und Arbeitgeber und dient zur Information für alle weiteren Akteurinnen und Akteure des praktischen Arbeitsschutzes. 2. Zusammensetzung der Leitliniengruppe: Beteiligung von Interessensgruppen o Repräsentativität der Leitliniengruppe: Beteiligte Berufsgruppen (s. DELBI-Kriterium 4) Die Mitglieder der Leitliniengruppe sind Ärztinnen und Ärzte sowie Wissenschaftlerinnen und Wissenschaftler aus den Bereichen Arbeitsmedizin, Arbeitswissenschaft, Ergonomie, Arbeitsschutz, Biomechanik, Orthopädie, Orthopädische Chirurgie und Unfallchirurgie, Neurologie, Schmerzforschung sowie Sozialmedizin und Prävention. Zudem sind Vertreter der Deutschen Gesetzlichen Unfallversicherung, verschiedener Berufsgenossenschaften, der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin und aus dem Bereich der Rehabilitation mit einem hohen Bezug zur beruflichen Praxis in der Leitliniengruppe vertreten.

Introduction The first weeks after total knee arthroplasty (TKA) are crucial for the functional outcome. To improve knee mobility, a continuous passive motion (CPM) motor rail is commonly used during in-hospital rehabilitation. The single-joint hybrid assistive limb (HAL-SJ) is a new therapy device. The aim of the study was to improve patients’ range of motion (ROM), mobility, and satisfaction using the active-assistive support of the HAL-SJ. Materials and methods Between 09/2017 and 10/2020, 34 patients, who underwent TKA and matched the inclusion criteria, were randomized into study (HAL-SJ) and control (CPM) group. Treatment began after drain removal and was carried out until discharge. Primary outcome parameters were raised pre- and postoperatively and included the Oxford knee score (OKS), visual analog scale (VAS), and acquired range of motion. Furthermore complications caused by the device were recorded. Results OKS increased in both groups postoperatively, but only significantly in the HAL-SJ group. Postoperative pain improved in both groups without significant differences. Flexion improvement was significant in both groups between days 3/7 and 8 weeks postoperatively. We did not encounter any complications related to HAL-SJ. Conclusions In conclusion, use of the HAL-SJ during rehabilitation in the early postoperative period after TKA was safe without disadvantages compared to the control group and seems to have advantages in terms of daily life impairment.