title: Assessment of the function and resistance of sternoclavicular ligaments: A biomechanical study in cadavers.
abstract: BACKGROUND
  Few biomechanical studies have assessed the resistance of the ligamentous structures of the sternoclavicular joint, and none have reproduced the physiological movements of the joint. Determining the structures that are injured in sternoclavicular dislocations is important for the surgical planning of acute or chronic ligament reconstruction.
  
  
  METHODS
  Forty-eight joints from 24 human cadavers were studied, and they were divided into 4 groups of 12 joints each (retraction, protraction, depression and elevation). Biomechanical testing assessed primary and secondary failures. The mechanical resistance parameters between movements that occurred on the same plane (depression versus elevation, protraction versus retraction) were compared.
  
  
  RESULTS
  The posterior sternoclavicular ligament was the most injured structure during the protraction test, but it was not injured during retraction. The anterior sternoclavicular ligament was the most affected structure during retraction and depression. The costoclavicular ligament was the most affected structure during elevation. Joint resistance was significantly greater during protraction movements when compared to retraction (P<0.05).
  
  
  CONCLUSIONS
  The anterior sternoclavicular ligament was the most affected structure during retraction and depression movements. During protraction, lesions of the posterior sternoclavicular ligament were most frequent during elevation, and the costoclavicular ligament was the most frequently injured ligament. The resistance of the sternoclavicular joint was significantly greater during protraction movement when compared to retraction.
  
  
  METHODS
  IV, basic science, biomechanics, cadaver model.
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: J H
authors.initials: JH
authors.lastname: Negri
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: E A
authors.initials: EA
authors.lastname: Malavolta
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil. Electronic address: jhassuncao@uol.com.br.
authors.forename: J H
authors.initials: JH
authors.lastname: Assunção
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: M E C
authors.initials: ME
authors.lastname: Gracitelli
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: C A M
authors.initials: CA
authors.lastname: Pereira
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Bolliger Neto
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: A T
authors.initials: AT
authors.lastname: Croci
authors.affiliation: Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil.
authors.forename: A A
authors.initials: AA
authors.lastname: Ferreira Neto
mesh_terms: D002102:Cadaver; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000503:physiopathology* / Q000601:surgery; D019637:Orthopedic Procedures; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013247:Sternoclavicular Joint / Q000503:physiopathology* / Q000601:surgery
keywords: Basic research; Biomechanics; Cadaver model; Dislocations; Ligaments; Sternoclavicular joint