Assessment of the function and resistance of sternoclavicular ligaments: A biomechanical study in cadavers - 25/09/14

Doi : 10.1016/j.otsr.2014.07.011

J.H. Negri, E.A. Malavolta, J.H. Assunção ^⁎ , M.E.C. Gracitelli, C.A.M. Pereira, R. Bolliger Neto, A.T. Croci, A.A. Ferreira Neto
Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo (USP), São Paulo, Brazil

^⁎Corresponding author at: Rua Dr. Ovídio Pires de Campos 333 3rd floor, 05403-010 Cerqueira Cesar São Paulo/SP, Brazil.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 25 September 2014
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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).

Conclusion

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.