{"title":"胸锁关节感染患者扩大切除术后的功能预后","authors":"Jovan Vujic MD , Aljaz Hojski MD , Sandrine V.C. Dackam MD , Helga Bachmann BSc , Didier Lardinois MD","doi":"10.1016/j.atssr.2023.12.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>Only 4 of 14 patients (29%) had fever and elevated infectious parameters at diagnosis. <em>Staphylococcus</em> 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.</p></div><div><h3>Conclusions</h3><p>Extended surgical treatment of sternoclavicular joint infection in conjunction with assisted wound healing led to satisfying clinical and functional results.</p></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772993124000111/pdfft?md5=abe21c800320fa6c7d1caf229e3a32f5&pid=1-s2.0-S2772993124000111-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Functional Outcomes of Patients With Sternoclavicular Joint Infection After Extended Resection\",\"authors\":\"Jovan Vujic MD , Aljaz Hojski MD , Sandrine V.C. Dackam MD , Helga Bachmann BSc , Didier Lardinois MD\",\"doi\":\"10.1016/j.atssr.2023.12.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>Only 4 of 14 patients (29%) had fever and elevated infectious parameters at diagnosis. <em>Staphylococcus</em> 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.</p></div><div><h3>Conclusions</h3><p>Extended surgical treatment of sternoclavicular joint infection in conjunction with assisted wound healing led to satisfying clinical and functional results.</p></div>\",\"PeriodicalId\":72234,\"journal\":{\"name\":\"Annals of thoracic surgery short reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2772993124000111/pdfft?md5=abe21c800320fa6c7d1caf229e3a32f5&pid=1-s2.0-S2772993124000111-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of thoracic surgery short reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2772993124000111\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of thoracic surgery short reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2772993124000111","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Functional Outcomes of Patients With Sternoclavicular Joint Infection After Extended Resection
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.