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The Surgical Treatment of Pyogenic and Tubercular Infection in the Sternoclavicular Joint - Case Report -

흉쇄관절에 발생한 화농성 관절염과 결핵성 관절염의 수술적 치료 - 증례 보고 -

  • Kim, Young-Yul (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea) ;
  • Kwon, Jong-Beum (Department of Thoracic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea) ;
  • Lee, Yeon-Soo (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Sang-Il (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea) ;
  • Ji, Jong-Hun (Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea)
  • 김영율 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 권종범 (가톨릭대학교 의과대학 대전성모병원 흉부외과학교실) ;
  • 이연수 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 김상일 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실) ;
  • 지종훈 (가톨릭대학교 의과대학 대전성모병원 정형외과학교실)
  • Received : 2010.01.08
  • Accepted : 2010.05.11
  • Published : 2010.06.15

Abstract

Purpose: Here we report clinical results for surgical treatment of 2 cases of pyogenic arthritis and 1 case of tubercular arthritis, which only rarely develops in the sternoclavicular joint. Materials and Methods: From September 2003 to September 2008, we did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle in 3 patients and evaluated clinical results after short-term follow up. Results: All 3 patients were satisfied with their clinical results and none had any recurrences according to follow up X-rays and laboratory datas. The follow up MRI showed bone edema in the distal clavicle and proximal sternum and a little fluid retention around the sternoclavicular joint. Conclusion: Even though diagnosis of these diseases are made earlier, infection of the adjacent bone and osteomyelitis could already have developed. We did early marginal resection and thorough debridement of osteomyelitis of the sternum and distal clavicle and achieved satisfactory results.

목적: 흉쇄관절에는 드물게 발생하는 화농성 관절염과 결핵성 관절염에서 조기에 흉쇄 관절의 완전한 절제와 철저한 변연 절제술을 시행하여 그 치료 결과를 보고하고자 한다. 대상 및 방법: 2003년 9월에서 2008년 9월까지 본원에서 흉쇄관절에서 발생한 2예의 화농성 관절염과 1예의 결핵성 관절염에 대하여 수술적 치료를 시행한 환자들 세 예를 대상으로 진단 및 그 임상적 결과를 평가하였다. 결과: 1년 이상 추시한 단순 방사선 소견 및 혈액 검사상 염증의 소견은 호전되었으며, MRI소견상 원위 쇄골단과 흉골에 골부종과 함께 흉쇄 관절에 경도의 활액막염이나 액체 저류 소견 등이 관찰되었으나, 임상 증상은 호전되었으며 1년 이상 추시하여 더 이상의 재발 없이 좋은 결과를 얻을 수 있었다. 결론: 흉쇄관절에서 화농성 관절염과 결핵성 관절염은 드물게 발생하는 질환으로, 진단 시 이미 흉쇄관절 주위의 골로 파급되어 골수염의 소견이 관찰되므로 조기에 흉쇄 관절의 골수염에 대한 완전한 변연 절제술과 철저한 소파술을 조기에 시행하여 만족스러운 결과를 얻을 수 있을 것으로 보인다.

Keywords

References

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