초록접수 현황
| 15F-126 | 포스터 발표 |
Comparison of Stiffness and Anterior Translation in
Reconstructed Sternoclavicular Joints Treated for Dislocation with
Different Surgical Techniques: A Cadeveric Study
오중환, 홍순창, 변천성, 박일환
연세대학교 의과대학 원주세브란스기독병원 흉부외과학교실
Background : Although the dislocation of sternoclavicular joint is a rare occasion, it poses a high potential risk as many vital organs are located in thorax proximal to sternoclavicular joint1-6. Therefore, operative intervention is considered if anterior or posterior dislocation continue to recur or reduction attempts fail. The importance of sternoclavicular joint reconstruction is emphasized and various methods are attempted in clinical practice. However, biomechanical comparative analysis of these methods and biomechanical study of the structures that maintain the stability of sternoclavicular joint have been limited.
Methods : total of 24 cadaver specimens were secured, and each specimen was consisted of clavicle, sternoclavicular joint and the first rib. The mean age at the time of death was 72.9 ±10.5 year-old. There were 14 male cadavers and 10 females. Of the total 24 sternoclavicular cadaver specimens, 12 cadaver specimens were selected for a comparative analysis of load-stiffnesscurve between normal sternoclavicular joints and the joints after reconstruction.
Results : Stiffness
The joint stiffness regarding the anterior load decreasedfrom the normal SC joint in all three reconstruction methods (p=0.013). The reduction of stiffness was at approximately 75.3% for the hamstring tendon sling reconstruction, 49.9% for the subclavius tendon reconstruction, and 29.9% for the hamstring figure of eight reconstruction. (Table 2, 3).
3D motion analysis of SC joint translation
During humerus abduction between 0 to 90 degree on coronal plane, 1.45mm of anterior translation of the clavicle in relation to sternum was observed in the normal SC joint. The anterior translation was observed to be an average of 1.68mm in the case of the figure of eight reconstruction, an average of 1.81mm for the subclavicus reconstruction and an average of 2.8mm for the sling reconstruction. In comparison to the normal joint, each reconstruction method had slight increase in the degree of anterior translation of the clavicle to the level of the sternum. This increase in anterior translation had statistically significant difference between a normal joint and each of the three reconstruction type (Table 4,5,6).
Conclusion : In patients with anterior dislocation of the SC jointthat are irreducible or require surgical reconstruction, figure of eight reconstruction procedure using hamstring tendon showed better stiffness and minimal anterior translation of the clavicle during shoulder movement similar to the normal joint.
Methods : total of 24 cadaver specimens were secured, and each specimen was consisted of clavicle, sternoclavicular joint and the first rib. The mean age at the time of death was 72.9 ±10.5 year-old. There were 14 male cadavers and 10 females. Of the total 24 sternoclavicular cadaver specimens, 12 cadaver specimens were selected for a comparative analysis of load-stiffnesscurve between normal sternoclavicular joints and the joints after reconstruction.
Results : Stiffness
The joint stiffness regarding the anterior load decreasedfrom the normal SC joint in all three reconstruction methods (p=0.013). The reduction of stiffness was at approximately 75.3% for the hamstring tendon sling reconstruction, 49.9% for the subclavius tendon reconstruction, and 29.9% for the hamstring figure of eight reconstruction. (Table 2, 3).
3D motion analysis of SC joint translation
During humerus abduction between 0 to 90 degree on coronal plane, 1.45mm of anterior translation of the clavicle in relation to sternum was observed in the normal SC joint. The anterior translation was observed to be an average of 1.68mm in the case of the figure of eight reconstruction, an average of 1.81mm for the subclavicus reconstruction and an average of 2.8mm for the sling reconstruction. In comparison to the normal joint, each reconstruction method had slight increase in the degree of anterior translation of the clavicle to the level of the sternum. This increase in anterior translation had statistically significant difference between a normal joint and each of the three reconstruction type (Table 4,5,6).
Conclusion : In patients with anterior dislocation of the SC jointthat are irreducible or require surgical reconstruction, figure of eight reconstruction procedure using hamstring tendon showed better stiffness and minimal anterior translation of the clavicle during shoulder movement similar to the normal joint.
책임저자: 박일환
연세대학교 원주의과대학 원주세브란스기독병원 흉부외과학교실
연락처 : 박일환, Tel: 033-741-1341 , E-mail : nicecs@yonsei.ac.kr
