Recurrent anterior sternoclavicular joint instability secondary to clavicle fracture malunion treated by corrective clavicle osteotomy using 3D patient-specific guides and anterior sternoclavicular joint stabilisation

Abstract

Introduction

A midshaft clavicle fracture malunion can result in significant alteration to shoulder girdle biomechanics with increased load and torque across the SCJ, this can result in secondary damage to the SCJ capsule and instability.

We undertook a corrective clavicle osteotomy using 3D patient-specific guides (3DPSG) with an SCJ stabilisation in a series of patients with SCJ instability secondary to clavicle malunion.

Materials & Methods

Between September 2021 and December 2024 patients with SCJ instability secondary to a clavicle malunion that underwent corrective osteotomy and SCJ stabilisation were reviewed.

Results

A total of 5 patients were available for follow-up. The mean age at surgery was 25.8 years (16–35) and the mean follow-up was 35.4 months (24–48).

At final follow-up the Quick-DASH had dropped 32.72 (27.3–40.9) to 6.8 (0–4.5), Rockwood SCJ had risen 9.6 (9–11) to 15 (15), OSIS had risen 24.8 (18–31) to 47.6 (47–48) and the SANE had risen 48 (45–55) to 99 (95–100). All the SCJs were stable.

Conclusion

A corrective clavicle osteotomy using 3DPSG with an SCJ stabilisation for patients with anterior SCJ instability secondary to clavicle malunion provides satisfactory results in terms of clinical outcome and joint stability.

Level of Evidence

IV – Case Series