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Sternoclavicular dislocation: case report and surgical technique

机译:胸锁关节脱位:病例报告及手术方法

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摘要

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.
机译:肩锁关节脱位占肩cap带所有脱位的不到5%。胸锁关节前脱位的大多数病例均未出现症状。但是,有些患者可能会发展为慢性前路不稳并保持症状,因此在这些情况下需要手术治疗。在外伤性前部不稳定的情况下,文献中缺乏使用长掌腱重建的报道。尽管很少见,但这些损伤值得快速诊断和有效治疗,以避免将来出现并发症。本报告的目的是报道一名越野摩托车比赛者的案例,该运动员发展出了慢性锁骨关节前路创伤性不稳定性,并使用自体长掌肌腱进行了外科手术重建。该患者是一名33岁的男子,有以下病史:越野摩托车比赛中的动作发生跌倒后,锁骨的前锁骨脱位。最初开始采取保守治疗,包括使用功能性吊带治疗症状3周,并进行物理治疗3个月。我们选择根据Spencer和Kuhn的研究对“八位数”技术进行修改。在胸锁关节水平切开约10厘米的纵向切口。来自同侧长掌肌腱的移植物以改良的“八位数”形式通过孔,并将其末端缝合在一起。使用美国吊带将患者固定4周。随访6个月后,当需要移动胸锁关节时,患者不再出现疼痛或不稳。仍然存在轻微的不适和胸锁关节的轻微隆起,但并不影响患者的活动。因此,患者能够在手术后六个月重返赛车场。我们的研究提出了一例慢性锁骨前关节脱位的病例,该病例通过改良“八位数”重建技术成功治疗。该技术被证明是安全有效的,它使患者能够完全恢复其体育活动。

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