Management and Outcomes of Sternoclavicular Joint Infections: A Retrospective Study

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Thoracic Surgery

Background:

• Sternoclavicular joint infections (SCJIs) are exceptionally rare, accounting for less than 1% of septic arthritis cases.
• Prompt diagnosis and effective management are critical due to the potential for severe complications.

Purpose of the Study:

• To evaluate the surgical and non-surgical management strategies for SCJIs.
• To analyze patient outcomes associated with different treatment approaches.

Main Methods:

• Retrospective analysis of 55 patients treated between 2005 and 2023.
• Data collection on patient characteristics, treatment modalities (surgery, debridement, NPWT, muscle flaps), and outcomes.
• Multivariate analysis to identify predictors of sepsis and complications.

Main Results:

• 90.91% of patients underwent surgery, with debridement and negative pressure wound therapy (NPWT) followed by joint resection being common.
• Staphylococcus aureus was the most frequent pathogen; elevated CRP and leukocyte levels predicted sepsis.
• 36.36% of patients experienced postoperative complications, but no 30-day mortality was observed.

Conclusions:

• SCJI necessitates urgent surgical intervention.
• Combination of surgical resection with NPWT and/or myocutaneous flaps demonstrates effectiveness.
• Close monitoring of inflammatory markers is vital for early sepsis detection and improved outcomes.