Sternoclavicular Reconstruction Technique

synonyms: SC reconstruction, sternoclavicular repair,

SC Reconstruction CPT

SC Reconstruction Indications

• Acute Posterior SC joint dislocation which can not be reduced closed.
• Symptomatic chronic anterior or posterior SC dislocation

SC Reconstruction Contraindications

• Asymptomatic chronic SC dislocation
• Acute Anterior SC dislocation
• Physeal facture

SC Reconstruction Alternatives

• Non-operative treatment.

SC Reconstruction Pre-op Planning / Special Considerations

• Consider having CT surgeon available. 
• Type and crossed blood available.
• Semitendinosis figure-of-eight reconstruction technique has been shown to be biomechanically superior (Spencer EE, JBJS 2004;86:98)
• Good outcomes have been reported with suture anchor reconstruction (Abidden Z, JSES 2006;15:315).

SC Reconstruction Technique

• Sign operative site
• Pre-operative antibiotics, +/- regional block
• General endotracheal anesthesia
• position. All bony prominences well padded.
• Examination under anesthesia.
• Prep and drape in standard sterile fashion.
• Irrigate.
• Close in layers.

SC Reconstruction Complications

SC Reconstruction Follow-up care

• Figure of eight brace with sling for 4-6 wks. Obtain follow-up radiographs.

SC Reconstruction Outcomes

• 60% stable, pain-free joints, 87% some limitations of athletic or recreational activity for SCJ reconstruction and medial clavicular resection for chronic anterior sternoclavicular joint instability (Bae DS, JPO 2006;26:71).

SC Reconstruction Review References

• Wirth MA, in Complex and Revision Problems in Shoulder Surgery, 2005. ISBN-10: 0781746582
• Wirth MA, JAAOS, 1996;4:268
• Rockwood and Green's Fractures in Adults 6th ed, 2006
• OKU - Shoulder and Elbow 2nd ed, 2002

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