Clinical Effect of Button Plate Fixation in the Treatment of Anterior Sternoclavicular Joint Dislocations

Abstract

Objective: Multiple reconstruction approaches for the anterior sternoclavicular joint have been described. No gold standard technique has been established. Owing to the well-established role of open reduction and internal fixation by means of plates and/or screws, rigid fixation is associated with the risk of implant failure, migration, and need for removal. This study aimed to evaluate the safety and efficacy of using button plates for the treatment of anterior sternoclavicular joint dislocation.

Methods: From January 2018 to May 2021, seven patients with a median age of 47 (range 37–57) years were treated for traumatic anterior sternoclavicular joint dislocations. The American Shoulder and Elbow Surgeons score (ASES), the visual analog scale (VAS) for pain and abduction, and forward elevation of the shoulder were used to evaluate clinical outcomes before the index surgery, at the removal of the implant, and at the latest follow-up. The satisfaction of patients was measured with the standard of Marsh.

Results: Open surgical reduction and sternoclavicular joint repair were successfully achieved in all the patients. They were also followed up, for a mean duration of 16.14 months. The mean postoperative abduction angle of the glenohumeral joint was 165.43 (range, 149°–173°), and the angle of one glenohumeral joint was less than 160 (149). The mean posterior extension angle of the glenohumeral joint was 26° (range, 24°–30°). The mean forward flexion was 161.25° (range, 150°–168°), and the horizontal extension was 39.57° (range, 35°–45°), respectively. According to the ASES scoring system, the mean postoperative physical function was 89.58, which was an improvement from the mean preoperative function, which was 25.48. There were no complications, wound infections, blood vessel or nerve injuries, or fixation failure. The patient satisfaction rate was 100%.

Conclusion: Button plate fixation technique is safe, simple, and effective and has been successfully used in treating sternoclavicular joint dislocation, with excellent functional outcome.

Keywords

anterior sternoclavicular joint dislocation / button plates / internal fixation / physical function / satisfaction

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