Reconstruction of the Sternoclavicular Joint After Excessive Medial Clavicle Resection
| Autor: | Xueling Chong, Alexandre Lädermann, Sean W. L. Ho, Sidi Wang, Marko Nabergoj |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Clavicle resection
medicine.medical_specialty business.industry Sternoclavicular joint Technical note Surgery Conservative treatment medicine.anatomical_structure Clavicle medicine Costoclavicular ligament Postoperative results Technical Note Orthopedics and Sports Medicine Surgical treatment business |
| Zdroj: | Arthroscopy Techniques |
| ISSN: | 2212-6287 |
| Popis: | Medial clavicle excision is a rarely indicated procedure and may be performed in different pathologies affecting the medial clavicle. Excessive medial clavicle resection with an injury to the costoclavicular ligament often leads to poor postoperative results. The exact surgical treatment used in this kind of pathology when conservative treatment is unsuccessful remains unclear. The aim of this Technical Note is to describe our preferred surgical technique to treat this condition. Technique Video Video 1 Surgical technique demonstration of reconstruction of the SCJ after excessive medial clavicle resection. An iliac crest autograft is first harvested. The size of the graft is determined by the size of the clavicle defect. A 1/3 tubular plate can be applied after graft harvest onto the iliac crest to prevent cosmetic deformity. An incision is made over the medial clavicle and sternum, and the medial clavicle is exposed. It is revitalized with an oscillating saw and rongeur. The sternal portion of the SCJ is exposed, preserving the capsule. The first rib is exposed and two strands of Ethibond 5 are passed through it. Two tunnels are drilled from the anterior sternal edge to the sternal articular surface. The iliac crest bone graft is shaped to the defect size, with a horizontal tunnel drilled through it to pass the gracilis allograft. The iliac crest bone graft is fixed to the native clavicle with a 3.5mm limited-contact dynamic compression plate. The sutures from the first rib are passed around the clavicle. The gracilis allograft ends are introduced into the sternal tunnel in a figure-of-eight configuration. The joint is reduced, and the graft is sutured onto itself. The sutures from the first rib are tied around the clavicle for the final costoclavicular stabilization. Pooled saline solution is used to check for pneumothorax. The capsule and platysma are approximated and closed. |
| Databáze: | OpenAIRE |
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