[Current trends in reverse fracture arthroplasty].

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Abstract

[Indexed for MEDLINE] 11. J Shoulder Elbow Surg. 2021 Jul;30(7):e392-e398. doi: 10.1016/j.jse.2020.09.015. Epub 2020 Oct 8. Complications after sternoclavicular surgery. van Diek FM(1), Kosse NM(2), van der Pluijm M(3), Dorrestijn O(3). Author information: (1)Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, the Netherlands. Electronic address: f.vandiek@gmail.com. (2)Research Department, Sint Maartenskliniek, Nijmegen, the Netherlands. (3)Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, the Netherlands. BACKGROUND: Sternoclavicular joint (SCJ) pathologies such as instability are rare; therefore, SCJ surgery is performed infrequently. Complications of these surgeries can be devastating. This study evaluated complications, and particularly infections, after SCJ surgery. METHODS: A retrospective cohort of 68 patients who underwent SCJ surgery with a minimum follow-up of 1 year was reviewed. Patients' characteristics, intraoperative, and postoperative complications were retrieved. In case of a reoperation, relevant data from the reoperation and microbiological findings were collected. RESULTS: Twenty-two men and 46 women with a mean age of 37.5 years (range, 13-70 years) were analyzed. A complication occurred in 26 of 68 patients (38.2%). In 16 patients (23.5%), this was an infection. Cutibacterium acnes was the pathogen in 14 of these infections. Infection occurred more often in men than in women (P = .02). A total of 26 reoperations were performed in our cohort: 14 due to clinical signs of infection, 9 due to instability, 1 due to complaints of SCJ osteoarthritis, and 2 due to other causes. CONCLUSION: Complications after SCJ surgery occur more often than previously described. C. acnes infections are often seen. When left untreated, these complications can lead to persistent complaints or recurrent instability due to failure of reconstruction. Therefore, it is of utmost importance to identify infections at an early stage, or better, to prevent them. The use of benzoyl peroxide gel preoperatively seems effective in reducing early C. acnes infections in this type of surgery. Copyright © 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jse.2020.09.015