Functional Upper Limb Assessment After Sternal Clavicular Joint Resection Without Prosthetic Reconstruction

Abstract

The Sternal Clavicular Joint (SCJ) resection is used as a treatment for SCJ infections. Reconstruction with a prosthesis can lead to reinfection, but theoretically, it is preferable due to functional impairment risk. However, the post-operative functional upper limb evaluation is poorly documented. The objective is to assess the upper limb function after SCJ resection and reconstruction without a prosthesis to determine if there is any functional impact and to grade it. We performed clinical and functional evaluations of patients with SCJ resected and reconstructed without prosthesis as treatment of SCJ infection in the period between 2012-2018. The evaluation was composed of a questionnaire (pain scale and daily activity evaluation) and examination (inspection, mobility and strength). 9 patients were assessed, from whom 7 had unilateral surgery. The questionnaires regarding pain and daily activities limitations showed improvement in 100% of the cases. Just one case of possible nerve injury with paresthesia. On the physical exam, only small alterations on inspection were found in 8 patients. Mobility was considered normal in 33%, partially impaired in one test in 22% and partially impaired in two or more tests in 44% of cases. Strength was graded 5 (maximum strength) and symmetric in seven patients. Patients after SCJ resection without prosthetic reconstruction showed a good outcome, especially on pain and daily activity. Even though, a small impact in mobility and strength has occurred.