Comparison of the advantages and disadvantages of multiple implants in treatment of traumatic dislocation of sternoclavicular joint / 中国组织工程研究

ABSTRACT

BACKGROUND: Traumatic dislocation of sternoclavicular joint is a rare disease in orthopedics, which can cause misdiagnosis and improper treatment. Its operation technology is constantly improving, mainly because of the improvement of the internal objects. OBJECTIVE: To explore the new progress in the diagnosis and treatment of traumatic dislocation of sternoclavicular joint, and to summarize the key points and the advantages and disadvantages of operation with various implants. METHODS: The Chinese database of Wanfang and China National Knowledge Infrastructure was searched by the first author. The key words were “dislocation of sternoclavicular joint; biomechanics; implants; internal fixation; tendon reconstruction; complications; prognosis”. Simultaneously, the English database of PubMed was searched, with the search term of “dislocation of sternoclavicular joint; biomechanics; implant; internal fixation; tendon reconstruction; complications; prognosis”. The retrieval period was from July 2010 to February 2020. RESULTS AND CONCLUSION: (1) Traumatic dislocation of sternoclavicular joint is a kind of trauma which is easy to be missed and may be fatal. Computed tomograhy and B-ultrasound can be used to confirm the diagnosis. Magnetic resonance imaging can show the damage of mediastinum structure. (2) Surgical treatment methods include Kirschner wire tension band internal fixation, hook plate internal fixation, locking plate internal fixation, ligament strengthening and reconstruction technology, joint replacement and so on. The fixation strength of Kirschner wires and steel wires is unsatisfactory and its complication rate is high, but they can be used in juvenile patients. The cross joint steel plate does not meet the biomechanical requirements of the fretting joint, so it is difficult to achieve firm fixation. The hook steel plate belongs to the built-in object of elastic fixation, and the disadvantage lies in the abrasion and stimulation of the bone caused by the tail hook structure. More and more attention has been paid to ligament reconstruction technology, which not only meets the needs of strength, but also conforms to the characteristics of biomechanics.