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At least 307 records · Page 17Linked to original sources
PubMed1976

[Migration of the wire after osteosynthesis].

In a 20 year old woman, sudden death due to hemopericardium ensued on osteosynthesis with Kirschner wire of a dislocated sternoclavicular joint. The wire moved to the aorta ascendens and to the right auricle thus causing lethal bleeding into the pericardium. The pathogenesis of the wandering wire is discussed and compared with observations in the literature describing causes, history and clinical phenomena. Wandering after osteosynthesis due to dislocation of the sternoclavicular joint is particularly dangerous, whereas in the case of broken clavicle, dislocation of the acromioclavicular joint, fracture of the humereus or in the region of the hips, no serious complications occur as a rule. Present-day text-books on surgery do not make sufficiently detailed reference to the wandering wire syndrome.

Adult↗
PubMed1991

Computed tomography in the evaluation of arthritis.

The role of computed tomography in rheumatologic imaging is limited primarily to joints that have complex anatomy and those obscured by overlying structures. Computed tomography is useful in the evaluation of sacroiliitis, arthritis of the subtalar joints, talocalcaneal coalition, preoperative assessment of the hip and shoulder, abnormalities of the sternoclavicular joint, chondromalacia patellae, and patellofemoral joint subluxation. Although CT is useful in examining ankle tendons, magnetic resonance imaging is preferred.

Ankle Joint↗
PubMed1986

Sternoclavicular dislocation. A plea for open treatment.

I report 12 cases of dislocation of the sternoclavicular joint. Eight cases were treated by closed reduction and redislocation occurred in five. The result was good in five out of these eight cases. Two cases with a redislocation and poor result were operated on: in one the sternoclavicular joint was successfully reconstructed with a palmaris longus tendon, and in the other the result was poor after medial resection of the clavicle. In four dislocations good results were obtained after primary open reduction, fixation with two Kirschner wires, and suture of the ruptured ligaments. Primary open reduction should probably be preferred in acute cases of sternoclavicular dislocation.

Adult↗
PubMed2006

Anatomical considerations of the anterior approach for central venous catheter placement.

Central venous catheterization (CVC) entails the catheterization of the superior vena cava via either the subclavian or the internal jugular vein (IJV). This study looked at the frequency in which a needle was inserted into the IJV using the anterior CVC approach, which entails inserting the needle into the apex of Sedillot's triangle, formed by the sternal and clavicular heads of sternocleidomastoid (SCM). The ipsilateral distances from the apex of Sedillot's triangle to the superior aspect of the sternoclavicular joint and the diameter of the IJV were also measured. A needle was inserted into the apex of Sedillot's triangle in 36 adult cadavers with mean age of 62 +/- 19 years (mean +/- SD), mean height of 1.6 +/- 0.18 m, and a mean weight of 55 +/- 16 kg. Subsequent dissections of this area revealed the relation of the needle to the IJV. Results indicate that on the right, the needle was inserted into the IJV in 97.14% of the cases. On the left, the needle entered the IJV in 78.79% of the cases. From the sternoclavicular joint, the apex of Sedillot's triangle was found to be 40.87 +/- 1.62 mm and 38.73 +/- 6.34 mm on the right and left, respectively. The IJV diameter was 17.29 +/- 1.07 mm on the right and 15.30 +/- 0.25 mm on the left. We conclude that the anterior CVC approach is an anatomically accurate technique. It is furthermore important to realize that when performing any invasive procedure, a sound anatomical knowledge of the region is extremely important, as complications are often due to lack of understanding or misunderstanding of the relevant anatomy.

Adult↗
PubMed1986

Histologic comparison of the costochondral, sternoclavicular, and temporomandibular joints during growth in Macaca mulatta.

The costochondral joint (CCJ) is commonly used to replace defective mandibular condyles in children for the restoration of normal temporomandibular (TMJ) growth and function. However, continued and harmonious growth following rib grafting is the exception rather than the rule. This may be due to the differences in the growth characteristics of the costal cartilage and the condyle. A joint that is similar both developmentally and structurally to the TMJ is the sternoclavicular joint (SCJ). The purpose f this study was to describe histologically the SCJ and CCJ during growth in Macaca mulatta and to compare the histomorphologic features with those of the TMJ. Costochondral and sternoclavicular joints were obtained from infant, juvenile, adolescent, and adult Macaca mulatta. The histologic sections were compared with mandibular condyles of the same ages available in our laboratory. The results indicate that the TMJ and SCJ are very similar morphologically throughout the growth period. The clavicular head contained layers of cartilage typical of the mandibular condyle, i.e., articular, prechondroblastic, chondroblastic, hypertrophic, and endochondral ossification layers, at each age during growth. Like those in the condyle, the hypertrophic cartilage cells were arranged in an apparently random, noncolumnar fashion. The CCJ, however, did not resemble the condyle but appeared to be more similar to the growth plate in a long bone epiphysis during growth. The results of this investigation indicate that the SCJ may be more suitable for mandibular condylar replacement than the CCJ.

Age Factors↗
PubMed1983

The surgical treatment of the rheumatoid shoulder.

Rheumatoid disease of the shoulder may affect not only the gleno-humeral joint but also the other joints of the shoulder girdle complex. Excision arthroplasty of the acromioclavicular and much less commonly of the sternoclavicular joints may be necessary to relieve persistent symptoms. Bursectomyin conjunction with anterior acromioplasty should provide a definitive solution to rheumatoid involvement of the subacromial bursa when this fails to respond to simple aspiration and hydrocortisone injection. Synovectomy has been little employed and perhaps deserves re-appraisal with regard to its role in the management of early cases of glenohumeral disease. Where pain is the predominant presenting symptom and until such time as joint replacement becomes more fully established and reliable double osteotomy may be worth considering as a very simple and in no way irrevocable surgical procedure. Glenoidectomy on the other hand should probably be regarded as obsolete except in cases where total joint replacement will be permanently contra-indicated. Even then arthrodesis may provide a stronger more stable and lasting solution, but before this operation is exhibited, pre-operative investigation must establish that the patient will be able post-operatively to remain independent with regard to routine activities of daily living and in particular perineal toilet. Arthroplasty of the shoulder must still be regarded as being in the developmental if not frankly experimental stage. The results from several sizeable series however are now beginning to show promising results. Moreover the pendulum is tending to swing towards the concept of a minimally constrained joint such as the Neer prosthesis which will mimic anatomical function and minimise the risks of scapular loosening. Careful attention to the soft tissues and very intensive and prolonged post-operative physio-therapy are vital to a successful outcome. It remains to be seen however whether more constrained joints would provide better functional results in the rheumatoid patient with severe bone erosion and rotator cuff destruction. In spite of the problems still to be solved, the author would regard total joint replacement as being the treatment of choice in the markedly eroded gleno-humeral joint presenting with severe pain and limitation of function. Moreover in the event of mechanical failure or infection, it would still seem to be possible to salvage adequate painfree function either by removal of the prosthesis and the creation of a pseudarthrosis or by arthrodesis.

Acromioclavicular Joint↗
PubMed1993

Surgical management of bipolar clavicular dislocation.

We present case of bipolar dislocation of the right clavicle in a 26 year-old man. He was treated by open reduction plus internal fixation with Kirschner wires at the acromioclavicular joint, and orthopedic reduction of the sternoclavicular joint plus percutaneous osteosynthesis with Kirschner wires. An excellent (functional and cosmetic) result was obtained. A review of the literature is included, and some aspects of the treatment are discussed.

Acromioclavicular Joint↗
PubMed2006

Posterior sternoclavicular epiphyseal fracture-dislocation with delayed diagnosis.

Posterior sternoclavicular joint dislocations and epiphyseal fractures are relatively rare injuries. We present a case report of a 16-year-old male who presented with a 10-day delay in diagnosis. The medial clavicular fragment was widely displaced and rested against the cervical vertebral body. Despite the degree of displacement, the patient had very few symptoms, and the diagnosis was not appreciated in the emergency department and became apparent at 10-day clinic follow-up. Treatment consisted of attempts at closed reduction, which were not successful. Open reduction was performed and the repair done with strong sutures. At 1-year follow-up the patient is doing well without any symptoms. A literature review consisting of anatomy, ossification patterns, classification systems, diagnosis and associated symptoms, imaging recommendations, treatment recommendations, outcomes, and complications is included.

Adolescent↗
PubMed2006

Unusual sites of Salmonella osteoarthritis in patients with sickle cell disease: two cases.

Salmonella osteoarticular infections involve mainly long bones such as the femur, tibia, and humerus in patients with sickle cell disease (SCD). We report here two unusual cases of Salmonella osteoarthritis affecting sacroiliac and sternoclavicular joints in two patients with SCD, one patient also being followed for rheumatoid arthritis. Because of misleading presentation, diagnosis of septic osteoarthritis in patients with SCD requires a high index of suspicion and an early treatment.

Adult↗
PubMed1978

Fracture and retrosternal dislocation of the clavicle.

A case of posterior fracture-dislocation of the sternoclavicular joint is described. This injury was successfully treated by open reduction and internal fixation. This rare injury is discussed and an alternative method of treatment is described.

Adult↗
PubMed1996

Posterior sternoclavicular dislocation: an American football injury.

Posterior dislocation of the sternoclavicular joint is uncommon, accounting for less than 0.1% of all dislocations. Since 1824 a little more than 100 cases have been reported, and the majority in the past 20 years. A review of published reports suggests that this injury is seen particularly in connection with American football. A typical case is described. The importance of this injury is that there is often a delay in diagnosis with potentially serious complications.

Adolescent↗
PubMed1999

Posterior fracture through the sternoclavicular physis associated with a clavicle fracture: a case report and literature review.

Three reported cases of fractures in teenagers of the medial clavicle associated with a posterior disruption at the sternoclavicular joint have similar findings. The medial fragment is rotated 90 degrees to the coronal plane. The medial fragment is usually stripped of its periosteum. Treatment requires open reduction and internal fixation of the clavicle fracture. We are reporting similar findings in a fourth case.

Adolescent↗
PubMed1986

Tripartite injury of the clavicle. A case report.

A rare injury of the clavicle and its articulations is reported. A possible mechanism of injury is suggested, and the management and outcome are discussed. The importance of being on the look-out for the potentially lethal posterior dislocation of the sternoclavicular joint is stressed.

Acromioclavicular Joint↗
PubMed2006

Pulmonary adenocarcinoma associated with SAPHO syndrome difficult to differentiate from multiple bone metastasis.

The patient was a 57-year-old man with a chief complaint of anterior chest pain who was diagnosed with clinical stage IV (c-T2N2M1) non-small-cell lung cancer (adenocarcinoma). Tenderness in the sternoclavicular joint, acne, periodontitis, and palmoplantar pustulosis were evident, and SAPHO syndrome was diagnosed. SAPHO syndrome is a rare disorder that results in synovitis, acne, pustulosis, hyperostosis, and osteomyelitis. Bone scintigraphy showed tracer accumulation in the costal cartilage, sternoclavicular joint, and cervical vertebrae 6-7. Although the bone lesions of SAPHO syndrome were difficult to differentiate from bone metastasis of pulmonary adenocarcinoma, metastatic bone tumors were ruled out by magnetic resonance imaging, computed tomography, and fluorodeoxyglucose positron emission tomography. There have been no previously reported cases of lung cancer with comorbid SAPHO syndrome. We report such a case and discuss the relevant literature, particularly that concerned with the evaluation of bone lesions.

Acquired Hyperostosis Syndrome↗
PubMed1987

[Individual variability of the projection line of the common carotid artery].

The investigation has been performed on 87 corpses of persons of both sex, that died after 60 years of age from the pathology not connected with any diseases in the neck organs. Individual variability in the common carotid artery projection line has been revealed; it conforms, to a certain extent, with the value of the neck index. When the neck is short and thick, the artery position corresponds to the line that runs across the following points: the superior--0.5 cm forward from the mandibular angle, the inferior--0.5 cm medially from the sternoclavicular joint. When the neck index is within the limits 1.71-1.88, it is expedient to draw the classical projection line. When the neck index is within the limits 1.57-1.69, it is possible to determine the projection zone as an elongated rectangle. At the bottom of every side the border of this zone is a straight line drawn between the sternoclavicular joint and the point situating 0.6 cm laterally from the joint, and at the top--the line connecting the top of the mastoid process with the point 1.0 cm behind the mandibular angle.

Carotid Arteries↗
PubMed2003

Bilateral retrosternal dislocation and hypertrophy of medial clavicular heads with compression to brachiocephalic vein.

A 36-year-old woman with effort dyspnea for 2 years, venous congestion of the left arm for 6 months and who did not have a history of a thoracic trauma was hospitalized. Posterior bilateral dislocation of the sternoclavicular joints and compression of the brachiocephalic vein were diagnosed and conformed by computed tomography (CT). The joint could not be reduced because of the old dislocation and destruction of the joint in the operation. The heads of the clavicles were resected and the vein compression was eliminated. Six weeks later, venous congestion disappeared and the brachiocephalic vein was patent.

Adult↗