Outcomes Following Internal Bracing for Anterior Sternoclavicular Joint Instability: A Systematic Review (2023)

Type of publication:
Conference abstract

*Kapur K.; *Zaki P.; Chaudhury S.; Tytherleigh-Strong G.; Panayiotou D.

British Journal of Surgery. Conference: ASiT Surgical Conference 2023. Liverpool United Kingdom. 110(Supplement 7) (pp vii168), 2023.

Aim: There is a paucity of data regarding optimal treatment strategies for atraumatic sternoclavicular joint (SCJ) instability, as this is a relatively uncommon aetiology. Atraumatic SCJ instability may be due to capsular laxity, muscle sequencing or a combination of both. This study aims to systematically review the literature regarding SCJ instability with isolated capsular laxity to determine whether anterior capsular surgical plication and augmentation with internal bracing can prevent further episodes of instability in a population that is refractory to non-operative management. Method(s): Studies that reported functional surgical outcomes were identified using the search terms "sternoclavicular AND joint AND dislocation AND reconstruction". Nine studies and a total of 111 patients were identified to have met the inclusion criteria. Result(s): Of the 111 patients identified, 9% of patients reported residual instability. 5.4% required a reoperation due to persistent impairment of shoulder function related to SCJ instability or osteoarthritis. There were satisfactory reported outcomes in 91% of patients. Conclusion(s): Internal stabilisation techniques for atraumatic sternoclavicular joint (SCJ) instability have shown to be an effective method to improve shoulder function and patient symptoms. Revision rates remained at only 5.4% with a significant improvement in functional status. Complications were rare and included haematoma formation and discharging wound site. Therefore, internal bracing techniques should be considered in patients with chronic anterior SCJ instability after a course of failed conservative treatment.

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