Sternoclavicular Joint Septic Arthritis Following Blunt Trauma: Successful Surgical Management and One-Year Outcome

钝性创伤后胸锁关节化脓性关节炎:手术治疗成功及一年预后

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Abstract

We report a case of sternoclavicular joint (SCJ) septic arthritis in a previously healthy non-smoker 63-year-old male following a direct blunt impact to the anterior chest, which served as the only identifiable predisposing factor. The patient presented with a two-month history of left SCJ pain, swelling, and a chronic draining sinus tract. Laboratory findings demonstrated leukocytosis and elevated inflammatory markers, while aspiration cultures grew methicillin-sensitive Staphylococcus aureus. Surgical management included irrigation and debridement of the SCJ with saucerization of the necrotic medial clavicle and sinus tract excision with fat pad flap closure of the SCJ, saucerization of the necrotic medial clavicle, and excision of the sinus tract with fat pad flap closure, followed by two months of intravenous antibiotics via peripherally inserted central catheter. Pathology revealed chronic active inflammation without acute osteomyelitis. The postoperative course was unremarkable, with normalization of inflammatory markers and complete wound healing. At the one-year follow-up, the patient demonstrated a painless full range of motion with no recurrence of infection. This case highlights an uncommon presentation of SCJ septic arthritis associated with trauma and showcases the importance of early recognition, surgical intervention, and multidisciplinary management in achieving durable outcomes.

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