切降性胸锁关节成形术治疗胸锁关节脱位

目的：探讨切除性胸锁关节成形术治疗胸锁关节脱位的临床应用可行性。方法：采用切除性胸锁关节成形术和修复或重建肋锁韧带治疗5例胸锁关节脱位的病例,并对结果进行平均1．8年随访、评价。结果：全部病例均随访平均1．8年,所有病人均获优秀效果,无感染、疼痛、畸形。结论：我们认为切除性胸锁关节成形术,保留或重建肋锁韧带是治疗胸锁关节脱位疗效可靠的方法。     

胸锁关节疾病二例报告

目的总结2例胸锁关节疾病的诊断及治疗,为临床治疗提供参考。方法 2004年2月及2011年6月收治2例胸锁关节疾病男性患者。年龄分别为61岁及50岁,病程分别为20 d及7 d。胸锁关节非特异性关节炎1例,手术清创后采用重建钢板固定胸锁关节;胸锁关节奇异变形杆菌感染1例,采用脓肿切开引流,局部病灶清除,抗感染及局部换药治疗。结果 1例胸锁关节非特异性关节炎患者术后随访8个月,切口愈合良好,病变未复发,肩关节活动无明显受限。1例胸锁关节奇异变形杆菌感染患者随访1年,功能恢复良好,病变未复发。结论胸锁关节疾病发病率低,疾病类型多样,诊断和治疗有待进一步研究探讨。     

胸锁关节感染1例

<正>患者,女,52岁,2017年4月18日因右胸锁关节周围出现疼痛,于当地医院就诊,以梅花针刺破右胸锁关节周围皮肤后进行拔罐治疗,之后局部出现红肿热痛及渗出伴随发热症状,最高温度可达38. 5℃,对症治疗后发热症状缓解,但局部红肿热痛症状未见消除。查体:右胸锁关节处可见3 cm×2 cm大小的发红区域,局部皮温高,肿胀明显,周     

锁定钢板跨关节内固定治疗不稳定胸锁关节损伤

目的探讨锁定钢板跨关节内固定治疗不稳定胸锁关节损伤的临床疗效。方法采用锁定钢板跨关节内固定治疗17例闭合不稳定胸锁关节损伤患者。结果患者均获得随访,时间6～22个月。除1例由于再次外伤导致固定失效予以翻修外,其余均获得满意疗效。术后6个月采用Rockwood评分标准评估疗效:优10例,良5例,一般2例。结论锁定钢板跨关节内固定治疗不稳定胸锁关节损伤稳定性强,并发症少,疗效满意。     

胸锁关节解剖锁定钢板联合韧带重建治疗胸锁关节前脱位

目的观察胸锁关节解剖锁定钢板联合韧带重建治疗胸锁关节前脱位的疗效。方法选取2015年1月至2018年1月西南医科大学附属医院骨科10例胸锁关节前脱位患者,行胸锁关节解剖锁定钢板联合韧带重建治疗。其中男7例、女3例,年龄(42.20±8.08)岁。所有患者在伤后2周内接受手术治疗,以Rockwood评分评价患者术前及术后肩关节功能。术后随访9～15个月,平均(12.05±1.19)个月。结果术后X线摄片示复位满意。术前、术后3d、1个月、6个月及末次随访时患者Rockwood评分分别为(5.30±1.16)分、(8.20±0.79)分、(10.30±1.06)分、(13.40±1.26)分和(13.50±1.18)分。与术前比较,术后3dRockwood评分明显改善(P0.05);术后1个月评分较术后3d有所改善(P0.05);术后6个月较术后1个月明显改善(P0.05);末次随访时与术后6个月的评分无差异(P0.05)。末次随访时患者肩功能评分优8例、良2例,优良率为100%。未见血管神经损伤、内固定松动及断裂、胸锁关节疼痛及包块等并发症发生。结论胸锁关节解剖锁定钢板联合韧带重建治疗胸锁关节前脱位可达到固定牢靠、并发症少、关节功能恢复好的效果,可作为处理胸锁关节前脱位的新方法。     

创伤性胸锁关节脱位治疗进展

创伤性胸锁关节脱位基本治疗原则是对症治疗、短期固定及康复治疗,以重获关节稳定,最大限度地恢复关节活动范围。习惯性脱位、持续性疼痛并导致功能障碍和情绪不良,以及难复性后脱位,需行手术治疗。克氏针固定导致严重并发症,现多不采用;钢板螺钉系统固定成为临床应用最普遍的内固定物;胸锁关节韧带重建术发展较快,但需重视自体供区并发症及异体肌腱移植的安全性问题;微创技术、符合胸锁关节生理活动特点的外科技术是目前治疗发展趋势。     

胸锁关节结核1例

1病例资料患者,女,50岁,左胸锁关节有黄豆粒大小肿物,无疼痛,未行任何处理。约1个月后,感左胸锁关节处肿物疼痛,就诊当地医院进行治疗,诊断未明确,患者症状无缓解,未继续治疗。肿物进行性增大、疼痛加重1个月,遂就诊于我院。无潮热、盗汗等症状。查体:左胸锁关节处可触及一1·5     

胸锁关节结核1例

骨与关节结核多发于负重大、活动多和易遭受慢性劳损的部位,以脊柱最为多见,发生于胸锁关节的结核在临床上极为少见,笔者收治1例,报道如下。     

胸锁关节脱位诊断与治疗的研究进展

胸锁关节脱位发病率低,约占肩胸部关节脱位的1%[1-2].随着交通事故的增多,其发病率逐渐增加;同时随着影像学技术的发展,尤其是CT、MRI在临床上广泛应用,也使得本病的检出率有所增加.关于其诊断,多数学者认为,对于有胸部外伤史的患者应行CT扫描以明确诊断,必要时行MRI检查[3-5].关于胸锁关节脱位的治疗目前存在争议,如何选择最佳的治疗方式以及合适的固定器械是骨科医师关注的重点.本文对相关问题进行综述.     

Acute and Chronic Traumatic Injuries of the Sternoclavicular Joint

Acute and chronic traumatic injuries of the sternoclavicular joint require accurate diagnosis and management if complications are to be avoided. Sternoclavicular subluxation or dislocation, medial clavicle physeal injuries, and degenerative arthritis are the most frequently diagnosed of these relatively uncommon injuries. The medial clavicular epiphysis does not ossify until the 18th to 20th year. Knowledge of its developmental anatomy is essential because most physeal injuries will heal with time without surgical intervention. In contrast, posterior dislocation of the sternoclavicular joint requires prompt closed or open reduction, as posterior displacement of the medial clavicle has been associated with numerous complications, including respiratory distress, venous congestion or arterial insufficiency, brachial plexus compression, and myocardial conduction abnormalities. A myriad of procedures have been recommended for repair or reconstruction of the sternoclavicular joint. On the basis of the authors' experience and review of the literature, they advocate surgical resection of the medial clavicle, with maintenance, repair, or reconstruction of the costoclavicular ligaments, when surgery is indicated. Metallic-pin fixation of the joint should be avoided, as Steinmann pins, Kirschner wires, threaded pins with bent ends, and Hagie pins have all been reported to migrate and cause serious complications, including death.     

新型胸锁关节解剖锁定钢板治疗锁骨近端骨折的临床疗效

目的 探讨新型胸锁关节解剖锁定钢板治疗锁骨近端骨折的临床疗效.方法 回顾性分析2018年1月至2020年10月在我院诊疗的13例锁骨近端骨折病人的临床资料,其中男8例,女5例,年龄为(53.54±7.40)岁(40～64岁),左侧4例,右侧9例.所有骨折均为闭合性骨折,受伤至入院时间为2 h～4 d.病人均采用新型胸锁...     

Sternoclavicular joint septic arthritis and mediastinitis. A case report and review of the literature

Septic arthritis of the sternoclavicular joint is rare. Its causes have been reported to include immuno-compromizing diseases, intravenous drug abuse, fractures of the clavicle or catheterization of the subclavian vein. We report a case of septic arthritis of the SCJ in a diabetic patient following periarticular injection of steroids in the ipsilateral shoulder, as this route of infection has not been documented, to our knowledge, in the literature to date. We review the literature regarding epidemiology and methods of surgical treatment that have been proposed, and present our own surgical experience. Bacterial infection should always be suspected in cases of SCJ arthritis. If surgery is required, it is important to remember that bony procedures leave vascular structures exposed, making their cover by myoplasty mandatory.     

创伤性浮膝伴血管损伤的早期诊治

目的 探讨创伤性浮膝同时伴同侧血管损伤患者的早期诊断及救治.方法 总结1996年6月～2002年12月收治28例30个浮膝的手术固定方法、血管修复情况及术后治疗和恢复情况.结果 术后伤口一期愈合5例,17例伤口二期行植皮修复,4例胫前骨折部外露二期行皮瓣转移术,截肢2例,保肢成功率92.9%.术后26例经18个月～8年随访,骨折均愈合,下肢功能恢复优良率64.3%.结论 对浮膝损伤患者应高度重视伴有血管损伤可能,早期作出诊断,积极合理治疗,对患者预后至关重要.     

Surgical Treatment of Dislocations of the Sternoclavicular Joint

Six patients with dislocation of the sternoclavicular joint are presented. Their main complaints were chronic recurrent spontaneous dislocation and local tenderness and discomfort during normal use of the shoulder. Two patients were treated according to Brown's modified procedure while four patients were operated with Burrow's technique. Ten weeks immobilization postoperatively is recommended to obtain a satisfactory result.     

Acromioclavicular Septic Arthritis and Sternoclavicular Septic Arthritis with Contiguous Pyomyositis

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.