Surgical management of sternoclavicular joint septic arthritis.

Document Type

Article

Publication Date

3-1-2019

Publication Title

J Clin Orthop Trauma

Keywords

Diagnostic algorithm; Infection; Resection arthroplasty; Risk factors; Septic arthritis; Sternoclavicular joint

Abstract

Introduction: Infections of the sternoclavicular joint (SCJ) account for less than 1% of all joint infections. There are no standardized diagnostic and therapeutic algorithms defined in literature. This study intended to report the risk factors, the bacterial spectrum, the extent and localization and the clinical outcome of SCJ infections.

Patients and methods: We retrospectively reviewed the medical charts of 13 patients (8 men, five women, mean age 37.6 years) with SCJ infections between Januray 1st 2008 and October 30th 2015 for clinical parameters and radiological studies. All patients were interviewed during their follow-up along with clinical examination and assessing the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH).

Results: Nine patients presented with local chest pain and swelling; in 4 patients, the prevalent symptom was pain without local signs of inflammation. Full blood count revealed a mean leukocytosis of 15 × 10

Conclusion: CT should be routinely obtained to recognize the possible extends to the surrounding structures. SCJ resection can result in satisfactory clinical results and should be considered in cases of extended infections including the surrounding structures. Empiric antibiotic coverage should contain cephalosporin or extended-spectrum penicillin. Inappropriate or less-invasive surgical procedures may cause recurrencent infections, especially in cases of osteomyelitis.

Clinical Institute

Neurosciences (Brain & Spine)

Clinical Institute

Orthopedics & Sports Medicine

Department

Orthopedics

Department

Neurosciences

Department

Surgery

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