OBJECTIVE: To investigate clinical effect of sternoclavicular hook plate in treating acute proximal clavicle fracture. METHODS: The clinical of 12 patients with acute unstable proximal clavicle fracture from June 2016 to June 2019 were retrospectively analyzed. There were 8 males and 4 females, aged from 46 to 63 years old. Ten patients caused by car accident and 2 patients caused by high falling. All patients had multiple injuries;the time from injury to surgery ranged from 2 to 14 d. All patients were treated with domestic sternoclavicular joint hook plate. The operative time ranged from 40 to 115 min. The intraoperative bleeding volume ranged from 30 to 110 ml, follow-up time ranged from 10 to 36 months, the fracture healing time ranged from 8 to 18 weeks. At the latest follow-up, the efficacy was evaluated by using shoulder joint function score (Rockwood score). RESULTS: All 12 patients were followed up, with no obvious pain at the latest follow-up. The rockwood scores of the affected shoulder ranged from 13 to 14, and the healthy shoulder ranged from 14 to 15. CONCLUSION The sternocleidoclavicular joint plate is fixed with preformed plate. The cantilever is designed to retain the motion of the sternoclavicular joint. It's safe and simple, avoid, the injury of important organs during operation, and has a good prognosis. It is an ideal fixation method for the treatment of proximal clavicle fracture.
Male ; Female ; Humans ; Middle Aged ; Clavicle/injuries* ; Sternoclavicular Joint/injuries* ; Retrospective Studies ; Fracture Fixation, Internal/methods* ; Treatment Outcome ; Fractures, Bone/surgery*

OBJECTIVE: To explore the efficacy of a novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint. METHODS: Retrospective analysis of 13 cases of proximal clavicle fracture with dislocation of sternoclavicular joint treated with sternoclavicular hook-plate from June 2011 to January 2019 in our department. There were 9 males and 4 females, aged 26 to 78 years old, with an average age of (54.08±13.91) years old. All the patients had closed injuries without damage of blood vessels and nerves. The patient's operation time, intraoperative blood loss, hospital stay time, and postoperative complications were recorded. Fracture healing and reduction were evaluated according to X-ray and CT after operation. Constant-Murley score and Rockwood sternoclavicular joint score were used to evaluate limb function at 12 months after operation. RESULTS: All the patients were treated with sternoclavicular hook-plate. The operation time ranged from 50 to 76 min, with a mean of (54.08±13.91) min. The intraoperative blood loss ranged from 20 to 56 ml, with a mean of (46.08±11.15) ml. The hospital stay time ranged from 6 to 14 d, with a mean of (8.31±2.32) d. X-ray and CT examination on the second day after operation showed that all fractures and dislocations were anatomically reduced, and shoulder joint function exercise was performed early. All patients were followed up, and the duration ranged from 12 to 24 months, with a mean of (16.77±4.63) months. The healing time ranged from 9 to 13 d, with a mean of (11.00±1.75) d;and the bone healing time ranged from 3 to 4 months, with a mean of (3.65±0.46) months. There were no complications such as infection, internal fixation failure and nerve injury. At 12 months follow-up, the constant Murley score ranged from 78 to 100, with a mean of 87.83± 11.26; and Rockwood score ranged from 9 to 15, with a mean of 13.70±1.85. Among them, 11 cases were excellent, 1 case was good, and 1 case was general. CONCLUSION The use of the novel sternoclavicular hook-plate for treatment of proximal clavicle fracture with dislocation of sternoclavicular joint is an effectively internal fixation with high safety, allowing early functional exercise for patients.
Adult ; Aged ; Bone Plates ; Clavicle ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; Humans ; Joint Dislocations ; Male ; Middle Aged ; Retrospective Studies ; Sternoclavicular Joint ; Treatment Outcome

Pustulotic arthro-osteitis (PAO) is a rare chronic inflammatory disorder characterized by inflammatory osteitis of the sternoclavicular joint and palmoplantar pustulosis. Here, we report a case of PAO that was successfully treated with a TNF-α inhibitor. A 45-year-old man presented with a 3-month history of pustular eruption on the palms and soles. Physical examination showed multiple erythematous papulopustules on the palms, back, and left shin, accompanied by sternoclavicular joint swelling and tenderness. Skin biopsy showed intraepidermal pustules filled with neutrophils on the palm. Bone scintigraphy revealed increased uptake in the bilateral sternoclavicular and other axial joints. Based on these findings, we made the diagnosis of PAO. Even after 6-month treatment of oral steroids and cyclosporine, skin manifestations insufficiently improved, so etanercept therapy was started. Complete clearance of skin lesions and joint pain were achieved after 3 months of etanercept therapy.
Arthralgia ; Biopsy ; Cyclosporine ; Diagnosis ; Etanercept ; Humans ; Joints ; Middle Aged ; Neutrophils ; Osteitis ; Physical Examination ; Radionuclide Imaging ; Skin ; Skin Manifestations ; Sternoclavicular Joint ; Steroids

Identification of certain abnormalities of the chest wall can be extremely helpful in correctly diagnosing a number of syndromic conditions and systemic diseases. Additionally, chest wall abnormalities may sometimes constitute diagnoses by themselves. In the present pictorial essay, we review a number of such conditions and provide illustrative cases that were retrospectively identified from our clinical imaging database. These include pentalogy of Cantrell, Klippel-Feil syndrome, cleidocranial dysplasia, Poland syndrome, osteopetrosis, neurofibromatosis type 1, Marfan syndrome, Gardner syndrome, systemic sclerosis, relapsing polychondritis, polymyositis/dermatomyositis, ankylosing spondylitis, hyperparathyroidism, rickets, sickle cell anemia, thalassemia, tuberculosis, septic arthritis of the sternoclavicular joint, elastofibroma dorsi, and sternal dehiscence.
Anemia, Sickle Cell ; Arthritis, Infectious ; Cleidocranial Dysplasia ; Diagnosis ; Gardner Syndrome ; Hyperparathyroidism ; Klippel-Feil Syndrome ; Marfan Syndrome ; Neurofibromatosis 1 ; Osteopetrosis ; Pentalogy of Cantrell ; Poland Syndrome ; Polychondritis, Relapsing ; Retrospective Studies ; Rickets ; Scleroderma, Systemic ; Spondylitis, Ankylosing ; Sternoclavicular Joint ; Thalassemia ; Thoracic Wall ; Tuberculosis

We report a case of fluoroscopy-guided intraarticular steroid injection for sternoclavicular joint (SCJ) arthritis caused by limited cutaneous systemic sclerosis (SSc). A 50-year-old woman diagnosed with limited cutaneous SSc presented with swelling and pain in the right SCJ. MRI revealed signs of inflammation consistent with right-sided sternoclavicular joint arthritis. After the failure of oral medications, we performed fluoroscopy-guided injection in this region. She reported complete resolution of her symptoms at 4 and 12-week follow-ups. This outcome suggests that a fluoroscopy-guided SCJ injection might be a safe and successful treatment option for sternoclavicular joint arthritis.
Arthritis* ; Female ; Fluoroscopy ; Follow-Up Studies ; Humans ; Inflammation ; Magnetic Resonance Imaging ; Methylprednisolone ; Middle Aged ; Scleroderma, Systemic* ; Sternoclavicular Joint*

PURPOSE: Currently, biomechanics and function comparison of the reconstruction of structures play important roles in the sternoclavicular joint stability is not much. In order to confirm the improvement in the functional aspects of the sternoclavicular joint after the three most widely used reconstruction methods, we measured the degree of anterior translation of the sternoclavicular joint after the operation using cadavers. MATERIALS AND METHODS: We studied 24 sternoclavicular joints in the cadavers. First, we measured the anterior translation of the clavicle, which was compared with the sternum in 24 normal sternoclavicular joints. We divided the cadaver into three groups and performed each of the three current operations: figure of eight hamastring tendon reconstruction operation (Group 1), subclavius tendon reconstruction operation (Group 2), and hamstring tendon reconstruction operation (Group 3); then we compared the degree of anterior translation in each group. We did the measurement by adding 10 degrees to the glenohumeral joint each time from 0 degrees to 90 degrees. RESULTS: In the normal joint, the clavicle was significantly ascended compared with the sternum. The Group 1 had a 1.68±0.25 mm anterior translation while the Group 2 had 1.81±0.23 mm and Group 3 had 2.8±0.58 mm (Group 1: p=0.004, Group 2: p=0.001, Group 3: p=0.002). The Group 1 showed a low ascending rate of up to 60 degrees, which showed no significant difference with that of the normal joint. However, after 60 degrees, the ascending rate showed a significant increase. In the case of Group 2, there was no significant difference with normal joint of up to 50 degrees. Group 3 showed significant anterior ascending from 20 degree. CONCLUSION: Through measuring the anterior translation of subjects that underwent three representative sternoclavicular joint reconstructions, we found that the result from the Group 1 was most comparable normal translation of the sternoclavicular joint.
Biomechanical Phenomena ; Cadaver* ; Clavicle ; Dislocations ; Joints ; Methods* ; Shoulder Joint ; Sternoclavicular Joint ; Sternum ; Tendons

A 22-year-old man was hospitalized with a sternoclavicular joint (SCJ) dislocation caused by a traffic accident. Surgical reduction and fixation of the SCJ were performed using a T-plate. SCJ dislocation is rare, accounting for less than 1% of all dislocations, and is usually treated conservatively, although severe cases may require surgery. Surgery typically involves joint reduction and fixation using an autologous tendon graft, but this has disadvantages such as the requirement for additional surgery to obtain autologous tissue and an extended operative time. To overcome these issues, here, we performed a simple SCJ reduction and fixation using a T-plate and achieved good results.
Accidents, Traffic ; Dislocations* ; Humans ; Joints ; Operative Time ; Sternoclavicular Joint* ; Sternum ; Tendons ; Transplants ; Young Adult

The prevalence of metastatic tumorous lesion at medial clavicle or sternoclavicular joint is low. Herein, we presented a 45-year-old female patient with left sternoclavicular joint pain followed a weight-lifting exercise. The patient was initially diagnosed as traumatic sternoclavicular arthrosis, however, on later computed tomography scan demonstrated the bony destruction of medial clavicle which was diagnosed as metastasized non-small cell lung carcinoma after a fine needle biopsy.
Adenocarcinoma ; Biopsy, Fine-Needle ; Clavicle ; Female ; Humans ; Lung Neoplasms ; Lung* ; Middle Aged ; Neoplasm Metastasis ; Prevalence ; Sternoclavicular Joint*

PURPOSE: The aim of this study is to evaluate the correlation between the location of the plate and the incidence of clavicular hypoesthesia and the clinical features of patients with clavicular hypoesthesia after open reduction and internal fixation of clavicular midshaft fractures. MATERIALS AND METHODS: Seventy-eight patients who underwent open reduction and plate fixation for clavicle midshaft fractures between March 2013 and October 2014 were assessed for eligibility. The total clavicular length (A), the distance to the medial end of the plate from the sternoclavicular joint (B), and the distance to the lateral end of the plate from the sternoclavicular joint (C) were measured. Correlation between the location of the clavicular plate and the incidence of clavicular hypoesthesia was evaluated. In addition, the severity, and recovery of hypoesthesia were evaluated. Patient satisfaction, pain visual analogue scale were evaluated regarding hypoesthesia. RESULTS: The incidence of hypoesthesia was 32.1% (25/78 patients). No correlation was observed with respect to the location of the clavicular plate and the incidence of clavicular hypoesthesia (p=0.666 at the medial end, p=0.369 at the lateral end). Recovery from hypoesthesia was observed in 23 out of 25 patients (p=0.008). Patient satisfaction and pain showed negative correlation with the incidence of hypoesthesia (p=0.002 and p=0.022). CONCLUSION: There was no correlation between clavicular hypoesthesia and the plate location. Although most cases of hypoesthesia were recovered, we should try to avoid hypoesthesia due to the negative 'correlation' with patient satisfaction and pain.
Clavicle ; Fracture Fixation ; Humans ; Hypesthesia* ; Incidence ; Patient Satisfaction ; Statistics as Topic ; Sternoclavicular Joint

Acromioclavicular (AC) and sternoclavicular (SC) septic arthritis with contiguous pyomyositis are rare, especially in immunocompetent individuals. We report a case of septic AC joint with pyomyositis of the deltoid and supraspinatus muscles and a separate case with septic SC joint with pyomysitis of the sternocleidomastoid muscle. Both patients had similar presentations of infections with Staphylococcus aureus and were successfully treated with surgical incision and drainage followed by prolonged antibiotic therapy.
*Acromioclavicular Joint/microbiology ; Adult ; Anti-Bacterial Agents/administration & dosage ; Arthritis, Infectious/diagnosis/microbiology/*therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Pyomyositis/diagnosis/microbiology/*therapy ; Staphylococcal Infections/complications/*therapy ; *Staphylococcus aureus ; *Sternoclavicular Joint/microbiology