Reconstruction of the Sternoclavicular Joint With an Autologous Fibular Head: A Case Report

Medial clavicle defects resulting from medial clavicle resection may lead to related complications and pain in patients. Additionally, the clavicle acts as a shield to protect the neurovascular structures located below the medial third; therefore, it is recommended to reconstruct the medial clavicle after resection. We report a unique case of autologous fibular head transplantation for sternoclavicular joint reconstruction, with the assistance of three-dimensional (3D) reconstruction and mixed reality (MR) technology. A 21-year-old female patient presented to the hospital with a painless mass in the right medial clavicle. The mass gradually grew larger and became painful during the following 2 months. There was no previous history of tuberculosis, fever, weight loss, or night sweats. Computed tomography angiography showed bone destruction and a soft tissue mass, with the lesion resembling a malignant bone tumor. Using preoperative 3D reconstruction and MR technology, the articular surfaces of the fibular head and clavicle were found to have a certain degree of similarity. Therefore, sternoclavicular joint reconstruction using the fibular head graft was performed. At the 1-year follow-up, the clavicular pain was completely relieved, the Constant-Murley score was improved, and the cosmetic effect was satisfactory. Current methods of clavicular reconstruction mainly include biotic and abiotic reconstruction. Among these, biotic autologous bone is a good material for the repair and reconstruction of bone defects. Three-dimensional reconstruction and MR can provide spatial visualization. In this case, this combination allowed complete resection and subsequent effective reconstruction.