ObjectiveTo investigate effectiveness of allogeneic tendon of " W” type knit in repair of traumatic anterior dislocation of sternoclavicular joint.MethodsBetween June 2013 and June 2017, 12 patients with traumatic anterior dislocation of sternoclavicular joint after poor conservative treatment were treated with allogeneic tendon of " W” type knit. Of them, 10 were males and 2 were females, aged from 25 to 58 years (mean, 42 years). All injuries were caused by traffic accidents. The time from injury to operation was 4-12 weeks (median, 6 weeks). All of them were closed injuries. The patients had no fracture around the shoulder, or blood vessels, nerves, and other adjacent limb joint injuries. The operation time, intraoperative blood loss, incision healing, and complications were recorded. The sternoclavicular joint was observed by X-ray film and CT at 1 year after operation. Visual analogue scale (VAS) score, University of California Los Angeles (UCLA) score, Rockwood score, modified Hospital for Special Surgery (HSS) score, and Constant-Murley score were used to evaluate the function of shoulder joint after operation.ResultsThe operation time was 60-80 minutes (mean, 70 minutes). The intraoperative blood loss was 50-100 mL (mean, 60 mL). Primary healing of incision was obtained in all patients without complications. All the patients were followed up 12-24 months (mean, 18 months). At 1 year after operation, X-ray film and CT examination showed that the position of sternoclavicular joint was satisfactory. At 1 year after operation, the Rockwood score was 12-14 (mean, 13). The UCLA score was 28-34 (mean, 31). The VAS score was significant lower than that before operation (P<0.05), and the Constant-Murley score and modified HSS score were significantly higher than those before operation (P<0.05).ConclusionThe repair of traumatic anterior dislocationr of sternoclavicula joint with allogeneic tendon of " W” type knit can effectively reconstruct the stability of the joint, retain the physiological fretting, and obtain satisfactory results.
Objective To summarize the method and effectiveness of open reduction and internal fixation in the treatment of 4 cases of bipolar clavicle dislocations. Methods Between June 2017 and June 2022, 4 patients with bipolar clavicle dislocations were admitted. There were 3 males and 1 female. The age ranged from 27 to 63 years, with an average age of 45 years. There were 2 cases of crushing injury of mine car, 1 case of traffic accident injury, and 1 case of heavy object injury. The time from injury to operation was 3-7 days, with an average of 5.0 days. The sternoclavicular joint dislocations were classified as Grade Ⅱ in 1 case and type Ⅲ in 3 cases, and anterior dislocation in 3 cases and posterior dislocation in 1 case. The acromioclavicular joint dislocations were classified as Tossy type Ⅱ in 2 cases and type Ⅲ in 2 cases. After open reduction, the sternoclavicular joint and acromioclavicular joint were fixed with lateral malleolus locking titanium plate and clavicular hook plate, respectively. ResultsAll operations were successfully completed without vascular or nerve injury. All incisions healed by first intention. All patients were followed up 12-18 months, with an average of 14 months. At last follow-up, the shoulder joint functions were rated as excellent in 3 cases and good in 1 case according to Rockwood score. During follow-up, there was no loosening of internal fixator or fracture. The internal fixators were removed in all patients at 5-7 months after operation (mean, 6 months), and no re-dislocation occurred after removal. Conclusion For bipolar clavicle dislocation, open reduction combined with lateral malleolus locking titanium plate fixation of the sternoclavicular joint and clavicle hook plate fixation of the acromioclavicular joint can achieve good effectiveness. It has the advantages of simple operation, high safety, firm fixation, and fewer complications, and the shoulder function recovers well.