title: Reconstruction of the sternoclavicular joint in active patients with the figure-of-eight technique using hamstrings.
abstract: BACKGROUND
  Dislocations of the sternoclavicular joint are rare injuries caused by massive forces applied to the joint. A high rate of complications has been reported following this injury emphasizing the importance of an accurate diagnosis and therapy.
  
  
  METHODS
  We report a series of patients with chronic anterior or posterior sternoclavicular instability treated with figure-of-eight gracilis- or semitendinosus-tendon reconstruction. Tendon grafts were collected from the patient's ipsilateral knee. Preoperative and postoperative DASH scores were compared to evaluate the outcome.
  
  
  RESULTS
  Six patients (mean age, 22 years; range 15-46; male = 3; female = 3) were included. The patients sustained an isolated dislocation of the sternoclavicular joint resulting from a high-energy trauma. Anterior instability was observed in 3 patients, posterior instability in 2 patients and the remaining patient showed multidirectional instability. The mean time from injury to operation was 8 months (range, 4-33). The semitendinosus tendon was used in 4 patients, the gracilis tendon in 2 patients, respectively. Follow-up examination was after 22 months (range, 14-34). The DASH score improved from 54.3 points (range, 45.7-68.8) preoperatively to 28.8 points (range, 25.8-34.5) postoperatively. All patients returned to full activity without limitations including competitive contact sports.
  
  
  CONCLUSIONS
  Stabilization of the sternoclavicular joint with the figure-of-eight technique seems to be a feasible alternative for young and active patients with remaining instability following conservative treatment.
authors.affiliation: Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria. georg.singer@medunigraz.at
authors.forename: Georg
authors.initials: G
authors.lastname: Singer
authors.forename: Peter
authors.initials: P
authors.lastname: Ferlic
authors.forename: Tanja
authors.initials: T
authors.lastname: Kraus
authors.forename: Robert
authors.initials: R
authors.lastname: Eberl
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000601:surgery*; D007593:Joint Instability / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D013247:Sternoclavicular Joint / Q000601:surgery*; D013710:Tendons / Q000637:transplantation*; D055815:Young Adult