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Chinese Journal of Shoulder and Elbow(Electronic Edition) ›› 2021, Vol. 09 ›› Issue (02): 136-141. doi: 10.3877/cma.j.issn.2095-5790.2021.02.006

Special Issue:

• Original Article • Previous Articles     Next Articles

Clinical effect of biplane fixation for unstable fracture and dislocation of anterior sternoclavicular joint

Jinhua Zhou1,(), Wenxi Zhang1, Guoqi Liu1, Biyu Rui2   

  1. 1. Department of Orthopaedics, Liyang People's Hospital, Liyang 213300, China
    2. Department of Orthopaedics, The 6th Affiliated People's Hospital of Shanghai Jiaotong University, Shanghai 200233, China
  • Received:2020-06-16 Online:2021-05-05 Published:2021-06-16
  • Contact: Jinhua Zhou

Abstract:

Background

Sternoclavicular joint fracture-dislocation is rare in clinic, most of which are anterior unstable fracture-dislocation. Due to the large trauma and poor healing, surgical intervention is often needed. However, the current fixation methods are different, and the fixation effect is not ideal. How to fix firmly has become an urgent problem to be solved in clinical practice.

Objective

To investigate the clinical effect of biplane fixation in the treatment of unstable fracture-dislocation of anterior sternoclavicular joint.

Methods

From March 2005 to March 2018, 36 patients with unstable sternoclavicular joint fracture-dislocation were retrospectively analyzed, with 18 patients treated with oblique "T" locking plate anterior fixation (single plane group) and 18 patients treated with oblique "T" locking plate anterior fixation and column plate inferior fixation (biplane group) . The operation time, intraoperative blood loss, postoperative incision infection rate, Rockwood shoulder function score of 1 year after operation and the rate of re dislocation were recorded.

Results

All patients were followed up for 12 to 16 months with an average time of (14.3±2.3) months. The average operation time was (62.89±11.95) min in the single plane group and (66.17 ± 7.92) min in the biplane group respectively, and there was no significant difference between two groups (P>0.05) . The average blood loss was (103.89±31.27) ml in the single plane group and (107.22±25.22) ml was in the biplane group, and there was no significant difference between two groups (P>0.05) . There was 1 case of incision infection occurred in the single plane group and 2 cases in the double plane group, and all improved after active surgical dressing change (P>0.05) . The Rockwood shoulder function score was (10.33±0.97) points in the single plane group and (12.61±1.79) in the biplane group half a year after the operation, and the difference was statistically significant (P<0.05) . The redislocation rate in single plane group was 38.89%, which was higher than that (5.56%) in the double plane group (P<0.05) .

Conclusion

Biplane fixation in the treatment of anterior fracture and dislocation of sternoclavicular joint has positive effect in preventing postoperative redislocation, and the shoulder joint function recovery is better after operation, which is worthy of clinical promotion.

Key words: Biplane, Oblique"T"plate, Sternoclavicular joint, Anterior dislocation

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