胸锁关节前脱位的分类和治疗:文献综述。

IF 1.7 Q2 SURGERY
JBJS Reviews Pub Date : 2025-04-28 eCollection Date: 2025-04-01 DOI:10.2106/JBJS.RVW.25.00011
Anas El Zouhbi, Ahmad Hammad, Mahmoud Hammad, Mohamad Nassereddine
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引用次数: 0

摘要

»闭合复位和物理治疗是大多数急性胸锁关节(SCJ)脱位的主要方法,对于低需求患者具有可接受的结果。然而,这些治疗有很高的复发性不稳定率,尽管对功能的影响很小。持续出现症状的复发性脱位通常需要手术干预。技术的选择——从不可吸收缝合线到自体肌腱移植和钢板——是基于个体化护理,考虑患者的活动水平、骨骼质量和健康状况等具体因素。*高需求的患者,如运动员,受益于强大的技术,如内部支架缝合修复或腘绳肌腱自体移植。这些方法提供了持久的稳定性和降低复发风险。»骨质量差的患者,如骨质疏松症患者,可能需要电镀技术(例如锁定钢板或scj特异性钢板)来确保刚性固定,尽管可能存在与硬件相关的并发症。由于这种疾病的罕见性和有限的研究,目前还没有标准化的治疗方案。根据临床和功能需求量身定制的方法可产生最佳结果,需要进一步研究以确定最佳做法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Anterior Sternoclavicular Joint Dislocation Classification and Management: A Review of the Literature.

» Closed reduction and physical therapy are the primary approaches for most acute anterior sternoclavicular joint (SCJ) dislocations, with acceptable outcomes for low-demand patients. However, these treatments have a high rate of recurrent instability, albeit with minimal functional impact.» Persistently symptomatic recurrent dislocations typically warrant surgical intervention. The choice of technique-ranging from nonabsorbable sutures to tendon autografts and plating-is based on individualized care by considering patient-specific factors such as activity level, bone quality, and health.» High-demand patients, such as athletes, benefit from robust techniques like suture repair with an internal brace or hamstring tendon autografts. These methods provide durable stability and reduce recurrence risks.» Patients with poor bone quality, such as those with osteoporosis, may require plating techniques (e.g., locking plates or SCJ-specific plates) to ensure rigid fixation, albeit with potential hardware-related complications.» Owing to the rarity of the condition and limited studies, no standardized treatment protocol exists. Tailored approaches based on clinical and functional needs yield optimal outcomes, and further research is needed to identify the best practices.

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来源期刊
JBJS Reviews
JBJS Reviews SURGERY-
CiteScore
4.40
自引率
4.30%
发文量
132
期刊介绍: JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.
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