Functional Outcomes of Patients With Sternoclavicular Joint Infection After Extended Resection

Abstract

Background

Sternoclavicular joint infection is rare. Operation is the treatment of choice, but there is no generally accepted approach. This report evaluated the clinical and functional results after extended surgical treatment.

Methods

This single-center cohort study included 14 patients. Extended operation consisted of initial débridement with removal of the joint capsule; partial resection of the ipsilateral manubrium sterni, of the medial part of the clavicle, and sometimes of the first rib; and vacuum-assisted closure dressing. The procedure was repeated until the microbiologic findings and surgical site showed healing. Analysis of the risk factors, complications, and recurrence rate was performed. Functional results were assessed by the shortened version of the standardized Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire.

Results

Only 4 of 14 patients (29%) had fever and elevated infectious parameters at diagnosis. Staphylococcus was the most frequently observed microorganism. Grade ≥III complications according to the Clavien-Dindo classification were observed in 5 of 14 (36%) patients. Recurrence was observed in 1 patient diagnosed 2 months after hospital discharge. Clinical and functional assessment after a mean follow-up of 48 months revealed excellent results without instability of the shoulder girdle, residual pain, or functional impairment. The mean QuickDASH score in our population was 4.5 of 100 points.

Conclusions

Extended surgical treatment of sternoclavicular joint infection in conjunction with assisted wound healing led to satisfying clinical and functional results.