Citation

Boesmueller S, Wech M, Tiefenboeck TM, Popp D, Bukaty A, Wolfgang H, Fialka C, Greitbauer M, Platzer P. J. Trauma Acute Care Surg. 2015; 80(2): 289-295.

Affiliation

° Department of Trauma Surgery, Medical University of Vienna, Austria $Division of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Austria §Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria *AUVA Trauma Hospital Meidling, Vienna, Austria #Department of Trauma Surgery, University Hospital St. Poelten, Lower Austria, Austria.

Copyright

(Copyright © 2015, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000000888

PMID

26491798

Abstract

INTRODUCTION: The majority of published studies concerning sternoclavicular injuries are case series, or systematic reviews. Prospective studies on the subject are hindered by the low incidence of these lesions. The aim of the present study was to provide an overview of this rare entity compared with literature and to present the long-term clinical outcome. MATERIAL AND METHODS: We performed a retrospective data analysis of all sternoclavicular injuries treated at a single level-I trauma center from 1992 to 2011. Long-term clinical outcome was assessed using the ASES (American Shoulder and Elbow Surgeons), SST (Simple Shoulder Test), UCLA (University of California-Los Angeles) and VAS (Visual Analogue Scale) at latest follow-up.

RESULTS: We detected an overall incidence of 0.9% of sternoclavicular injuries related to all shoulder-girdle lesions. Ninety-two patients (52 male and 40 female) with a mean age of 39.2 years ± 19.5 years (median 41 years; range, 4 to 92 years) were included in this study. The main trauma mechanisms were falls. Classification was performed according to Allman, the time point of treatment after initial trauma, and the direction of the dislocation. Nine patients of the 15 grade-III lesions were treated conservatively by closed reduction and immobilization while four patients were treated surgically by open reduction and internal fixation (ORIF). 49% of the patients were available for long-term follow-up at a median of 11.3 years (range, 5.3 - 22.6 years) with a mean ASES of 96.21, SST of 11.69, UCLA of 31.89 and VAS of 0.47.

CONCLUSION: We found an overall incidence of 0.9% of sternoclavicular joint injuries related to all shoulder-girdle lesions and of 1.1% related to all dislocations, which is slightly lower compared to literature. Furthermore, we observed a high number of physeal sternoclavicular injuries with a percentage of 16% and overall good to excellent results at long-term follow-up. LEVEL OF EVIDENCE: Level IV, retrospective epidemiological and clinical study.

Language: en