[Surgical management of sternoclavicular joint infections].
OBJECTIVE
The pyogenic infection of the sternoclavicular joint is a rare disease. The treatment can be conservative (antibiotics) or surgical (exposure and drainage of the joint or its resection). The authors analyze the causative and predisposing factors, the symptoms, the diagnosis, the questions of the therapy and its efficiency.


METHODS
In the 6 cases (5 male, 1 female, average age: 56.8 years) the cause of the disease were trauma or metastatic septic focus in 2-2 cases and intraarticular injection or preceding radiotherapy in 1-1 case. Predisposing diseases (diabetes mellitus, gout, chronic alcoholism, liver cirrhosis) could be proved in two cases. The most frequent symptoms were the swelling and erythema of the joint, fever, pain and limitation of motion. In all cases the CT scan proved the destruction of the joint. In one case after unsuccessful conservative therapy and in 1-1 case after debridement and drainage because of concomitant multiple septic focuses and mediastinitis resection of the sternoclavicular joint was applied in a later second step. In the other three patients primary resection of the joint was performed.


RESULTS
Both the conservative and drainage managements were insufficient. On the other hand the radical joint resection caused complete recovery in all cases. No intra and postoperative complications were observed. On an average 28.2 months after the radical operation the functional results were excellent.


CONCLUSIONS
Relying upon the results, radical resection is supposed to be the most effective method. Conservative treatment or drainage are recommended only for cases associated with severe complications. Resection is worthy performing after the recovery of the concomitant illnesses.
Szentkereszty
Zsolt
Z
DE OEC Sebészeti Intézet, Auguszta Sebészeti Központ, Debrecen.
Pósán
János
J
Petö
Katalin
K
Sápy
Péter
P
Boros
Miklós
M
Takács
István
I
Sz Kiss
Sándor
S
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D004322:Drainage; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015985:Precipitating Factors; D012189:Retrospective Studies; D012307:Risk Factors; D013247:Sternoclavicular Joint / Q000382:microbiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents