Combined gracilis tendon autograft reconstruction and discus repair of a chronic anterior–superior sternoclavicular joint dislocation

Friedrich, Lena; Afifi, Faik K.; Skarvan, Jiri; Friederich, Niklaus F.; Hirschmann, Michael T.

doi:10.1007/s00167-011-1852-y

Cited by 18 publications

(22 citation statements)

References 15 publications

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“…Several techniques for reconstructing the sternoclavicular joint have been introduced, including fixation with plates, fixation with anchors, fixation of the capsule and joint disk, reconstruction in a “figure of eight” using a graft from an autologous tendon and reconstruction using a graft from the sternocleidomastoid fascia. 1 , 4 , 15 Resection of the medial portion of the clavicle has also been reported. The ideal treatment still remains unknown, given that few studies have presented long-term results.…”

Section: Discussionmentioning

confidence: 99%

Sternoclavicular dislocation: case report and surgical technique

Terra

Rodrigues

Padua

et al. 2015

Revista Brasileira de Ortopedia (English Edition)

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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.

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Section: Discussionmentioning

confidence: 99%

Sternoclavicular dislocation: case report and surgical technique

Terra

Rodrigues

Padua

et al. 2015

Revista Brasileira de Ortopedia (English Edition)

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“…O tratamento ideal permanece desconhecido, já que há poucos estudos com resultados em longo prazo. Friedrich et al 15 submetidos a reconstrução da AEC com o enxerto entrelaç ado em "oito" através de túneis pré-perfurados. Poucos estudos relataram vantagem na reconstrução em "oito" relacionada a estabilidade primária.…”

Section: Discussionunclassified

“…12,14,15 Enxertos autólogos são usados a fim de evitar o riscos de infecção e para facilitar a integração do tecido, com o objetivo de um resultado positivo em longo prazo. Entre enxertos autólogos, acreditamos que o tendão do grácil e o do palmar longo, como por nós usado, sejam os ideais, pois o seu diâmetro resulta em menor morbidade.…”

Section: Discussionunclassified

Luxação esternoclavicular: relato de caso e técnica cirúrgica

Terra

Rodrigues

Padua

et al. 2015

Revista Brasileira de Ortopedia

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“…3,5,6 Numerous techniques are available for reconstruction of the SC joint in patients with anterior instability; however, a gold standard technique has yet to be defined owing to numerous described techniques and low levels of evidence. 4,[6][7][8][9][10][11][12][13][14][15] A biomechanical study by Spencer and Kuhn 16 suggested that SC joint reconstruction using a free tendon graft oriented in a figure-of-eight fashion is superior to other methods when comparing load-to-failure and the reestablishment of normal anatomy. It is therefore theorized that figure-of-eight SC joint reconstruction with tendon graft should result in improved clinical outcomes and patient satisfaction.…”

Section: Introductionmentioning

confidence: 99%