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Chekhovich YV, Khazov AV. Analysis of duplicated publications in Russian journals. J Informetr 2022. [DOI: 10.1016/j.joi.2021.101246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jagiasi JD, Upadhyaya MR, Mehta PK. Combined Pyogenic and Tuberculous Osteomyelitis of the Clavicle: A Case Report. J Orthop Case Rep 2021; 11:29-32. [PMID: 34141665 PMCID: PMC8180323 DOI: 10.13107/jocr.2021.v11.i02.2012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Tuberculous osteomyelitis of the clavicle accounts for 1–3% of cases of osteoarticular tuberculosis. It presents with non-specific symptoms and may have superadded infections with pyogenic organisms, requiring a high degree of suspicion to adequately diagnose and initiate appropriate treatment. Case Report: We describe a case of a 35-year-old male with osteolytic clavicular lesion and abscess in the supraclavicular fossa. Tissue diagnosis revealed tuberculous osteomyelitis with superadded infection with Staphylococcus aureus. He was managed with debridement and anti-tubercular therapy. Conclusion: A high degree of suspicion is required to adequately test and diagnose the cause of osteomyelitis of the clavicle, in the absence of a predisposing event, as staphylococcal and tuberculous infection can present simultaneously.
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Affiliation(s)
- Jairam D Jagiasi
- Department of Orthopaedics, Dr. R.N. Cooper General Hospital and H.B.T. Medical College, Mumbai, Maharashtra, India
| | - Mohit R Upadhyaya
- Department of Orthopaedics, Dr. R.N. Cooper General Hospital and H.B.T. Medical College, Mumbai, Maharashtra, India
| | - Parth K Mehta
- Department of Orthopaedics, Dr. R.N. Cooper General Hospital and H.B.T. Medical College, Mumbai, Maharashtra, India
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Thaddeus Chika A, Emeka OM. Whole clavicle sequestration from chronic osteomyelitis in a 10 year old boy: A case report and review of the literature. Ann Med Surg (Lond) 2016; 6:92-5. [PMID: 26981238 PMCID: PMC4777983 DOI: 10.1016/j.amsu.2016.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 11/17/2022] Open
Abstract
Chronic osteomyelitis is a childhood disease and so it is not uncommon to diagnose it in a 10 year old boy who is suffering from pains and discharging sinuses from the left shoulder girdle. What is not common is the involvement of the clavicle in this infective process and even more uncommon is for the whole length of the clavicle to sequester. This case report describes a rare case of chronic osteomyelitis of the left clavicle in which the entire length was removed as a sequestrum during surgery. And despite the removal of an entire length of the clavicle in the patient, there was no functional deficit and there was also no shoulder asymmetry. Chronic osteomyelitis is common in childhood and clavicular involvement is less common than femur, tibia or humerus. In this clavicular osteomyelitis, the entire bone was sequestered. It is not absolutely important to have huge involucrum before sequestrectomy since it is not a weight bearing bone. The whole sequestered clavicle was necessarily removed despite the thin involurcum. Regardless, the removal of the entire bone was not associated with functional deficit or shoulder asymmetry.
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Affiliation(s)
- Agu Thaddeus Chika
- Imo State University, Owerri, Nigeria; First Choice Specialist Hospital, Nkpor, Anambra State, Nigeria
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Pradhan C, Watson NFS, Jagasia N, Chari R, Patterson JE. Bilateral sternoclavicular joint septic arthritis secondary to indwelling central venous catheter: a case report. J Med Case Rep 2008; 2:131. [PMID: 18445257 PMCID: PMC2390578 DOI: 10.1186/1752-1947-2-131] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Accepted: 04/29/2008] [Indexed: 01/10/2023] Open
Abstract
Introduction Septic arthritis of the sternoclavicular joint is rare, comprising approximately 0.5% to 1% of all joint infections. Predisposing causes include immunocompromising diseases such as diabetes, HIV infection, renal failure and intravenous drug abuse. Case presentation We report a rare case of bilateral sternoclavicular joint septic arthritis in an elderly patient secondary to an indwelling right subclavian vein catheter. The insidious nature of the presentation is highlighted. We also review the literature regarding the epidemiology, investigation and methods of treatment of the condition. Conclusion SCJ infections are rare, and require a high degree of clinical suspicion. Vague symptoms of neck and shoulder pain may cloud the initial diagnosis, as was the case in our patient. Surgical intervention is often required; however, our patient avoided major intervention and settled with parenteral antibiotics and washout of the joint.
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Affiliation(s)
- Charita Pradhan
- Department of General Surgery, Kings Mill Hospital, Mansfield, UK.
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Balakrishnan C, Vashi C, Jackson O, Hess J. Post-traumatic osteomyelitis of the clavicle: A case report and review of literature. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2008; 16:89-91. [PMID: 19554172 PMCID: PMC2691560 DOI: 10.1177/229255030801600208] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Osteomyelitis of the clavicle is a rare form of infection occurring from hematogenous spread or trauma. This has been reported following head and neck surgery, and subclavian catheter placement. In traumatic cases, the management involves removal of bone fixation, debridement of the bone and coverage with a muscle flap.
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Affiliation(s)
| | - Christopher Vashi
- Department of Plastic Surgery, Wayne State University, Detroit, Michigan, USA
| | - Ollie Jackson
- Department of Plastic Surgery, Wayne State University, Detroit, Michigan, USA
| | - Jason Hess
- Department of Plastic Surgery, Wayne State University, Detroit, Michigan, USA
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Abstract
Adult osteomyelitis remains difficult to treat, with considerable morbidity and costs to the health care system. Bacteria reach bone through the bloodstream, from a contiguous focus of infection, from penetrating trauma, or from operative intervention. Bone necrosis begins early, limiting the possibility of eradicating the pathogens, and leading to a chronic condition. Appropriate treatment includes culture-directed antibiotic therapy and operative debridement of all necrotic bone and soft tissue. Treatment often involves a combination of antibiotics. Operative treatment is often staged and includes debridement, dead space management, soft tissue coverage, restoration of blood supply, and stabilization. Clinicians and patients must share a clear understanding of the goals of treatment and the difficulties that may persist after the initial course of therapy or surgical intervention. Chronic pain and recurrence of infection still remain possible even when the acute symptoms of adult osteomyelitis have resolved.
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Affiliation(s)
- Jason H Calhoun
- Department of Orthopaedic Surgery, University of Missouri-Columbia, DC053.00, MC213, Columbia, MO 65212, USA.
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Bar-Natan M, Salai M, Sidi Y, Gur H. Sternoclavicular infectious arthritis in previously healthy adults. Semin Arthritis Rheum 2002; 32:189-95. [PMID: 12528083 DOI: 10.1053/sarh.2002.37284] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To define characteristics of sternoclavicular infection (SCI) in previously healthy patients. METHODS SCI in a previously healthy man is reported along with 4 similar cases found by surveying the hospital's database; 22 previously reported cases were culled from the literature and summarized. RESULTS The frequency of SCI in healthy adults was 0.5% of all bone and joint infections admitted to the hospital. The clinical and bacteriologic features were similar to previous reports in nonselected SCI patients. Computerized tomography (CT) scan, arthrocenthesis, and biopsy were required for diagnosis. Complications included abscess formation, mediastinitis, and sepsis. The majority of patients were treated by surgical drainage and antibiotics. The final outcome was good, without mortality or long-term morbidity. CONCLUSIONS Although SCI is a rare infection in healthy adults, it should be considered in the differential diagnosis of a painful sternoclavicular joint. Prompt diagnosis and appropriate treatment of SCI results in excellent outcome in most cases.
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Affiliation(s)
- Michal Bar-Natan
- Department of Medicine C and Orthopedics and the Rheumatology Unit, The Chaim Sheba Medical Center, Tel Hashomer; and the Sackler Faculty of Medicine, Tel Aviv University, Israel
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Kruper LL, Low DW, Bucky LP. Immediate pectoralis flap closure following septic arthritis of the manubriosternal joint. Plast Reconstr Surg 2001; 107:997-9. [PMID: 11252094 DOI: 10.1097/00006534-200104010-00014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L L Kruper
- Division of Plastic Surgery, Hospital of the University of Pennsylvania, USA
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Girschick HJ, Huppertz HI, Harmsen D, Krauspe R, Müller-Hermelink HK, Papadopoulos T. Chronic recurrent multifocal osteomyelitis in children: diagnostic value of histopathology and microbial testing. Hum Pathol 1999; 30:59-65. [PMID: 9923928 DOI: 10.1016/s0046-8177(99)90301-5] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Chronic recurrent, unifocal or multifocal osteomyelitis (CRMO), an inflammatory disorder of unknown origin, involves different osseous sites and may be associated with palmoplantar pustulosis. Bacterial cultures of affected tissue were reported negative in nearly all cases. Radiological and magnetic resonance imaging features of CRMO have been described, but differential diagnosis remains difficult, including rheumatic diseases, bacterial osteomyelitis, and malignancy. Although definite diagnosis relies on histopathologic confirmation by biopsy, histopathologic criteria have not been defined. Because CRMO may be treated with nonsteroidal antiinflammatory drugs, but not antibiotics, distinguishing CRMO from bacterial osteomyelitis is of major importance. Histopathologic analysis of 12 patients with CRMO indicated a wide variation of reparative changes of bone, but chronic inflammation could not be found at all sites in the same biopsy. The inflammatory infiltrate was mostly scattered, consisting mainly of lymphocytes, plasma cells, histiocytes, and also few neutrophil granulocytes. Immunohistochemistry showed a predominance of CD3(+), CD45RO(+) T-cells, which were mainly CD8(+). In addition, CD20(+) B cells and CD68(+) macrophages were abundant in each biopsy specimen. Mild lymphocytic and granulocytic infiltrates were also detected in three synovial biopsy specimens obtained from adjacent joints. All bacterial and fungal cultures from native biopsy tissues were negative. Amplification of partial-length 16S ribosomal DNA by polymerase chain reaction (PCR) using broad-range eubacterial primers was below the detection limit in all patients. Because histopathologic features alone may not provide conclusive evidence, CRMO should be included in the differential diagnosis of chronic inflammatory bone lesions in children, and the definite diagnosis should be made by the clinical picture, x-ray studies, bone scan, bacterial culture, and histopathologic analysis in a multidisciplinary approach.
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Affiliation(s)
- H J Girschick
- Universitäts-Kinderklinik und Poliklinik, the Institut für Hygiene und Mikrobiologie, Universität Würzburg, Germany
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Abstract
OPAT for osteomyelitis is effective, safe, and well-established. There are particular considerations with osteomyelitis, however, that relate to patient selection and the plans of therapy. Orthopedic infections may impose physical considerations that need to be considered. Concomitant medical problems, such as diabetes, must be considered and may be good reasons for hospital care aside from the infection. Further investigations of treatment of osteomyelitis are clearly needed, with OPAT patients being good subjects to study.
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Affiliation(s)
- A D Tice
- Department of Medicine, University of Washington School of Medicine, Seattle, USA
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Judich A, Haik J, Rosin D, Kuriansky J, Zwas ST, Ayalon A. Osteomyelitis of the clavicle after subclavian vein catheterization. JPEN J Parenter Enteral Nutr 1998; 22:245-6. [PMID: 9661128 DOI: 10.1177/0148607198022004245] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Osteomyelitis of the clavicle or the sternoclavicular joint is a rare complication of subclavian vein catheterization. Soft tissue infections around the puncture site occur frequently and respond well to topical and antibiotic treatment. If symptoms persist for several weeks, osteomyelitis or sternoclavicular pyo-arthrosis should be considered. Bone and gallium scintigraphy scans and computerized tomography scans are helpful diagnostic measures.
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Affiliation(s)
- A Judich
- Department of Surgery B, Sheba Medical Center, Ramat Gan, Tel Hashomer, Israel
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12
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Carlos GN, Kesler KA, Coleman JJ, Broderick L, Turrentine MW, Brown JW. Aggressive surgical management of sternoclavicular joint infections. J Thorac Cardiovasc Surg 1997; 113:242-7. [PMID: 9040616 DOI: 10.1016/s0022-5223(97)70319-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although the sternoclavicular joint is an unusual site for infection, thoracic surgeons may preferentially be called on to coordinate management of cases refractory to antibiotic therapy because of the anatomic relationship of this joint to major vascular structures. METHODS Since 1994 we have surgically managed nine sternoclavicular joint infections in eight patients. Associated medical problems were frequent and included diabetes mellitus (n = 2), end-stage renal disease (n = 2), hematologic disorders (n = 2), and multiple joints affected by sepsis (n = 4). Open joint exploration with drainage and débridement with the use of general anesthesia was performed in four patients. The remaining four patients (one with bilateral sternoclavicular joint infections) had computed tomographic evidence of diffuse joint and surrounding bone destruction with infection extending into mediastinal soft tissues. Surgical therapy for these five joint infections involved en bloc resection of the sternoclavicular joint with an ipsilateral pectoralis major muscle covering the bony defect. RESULTS There were two deaths unrelated to the surgical procedure. After a mean follow-up of 20 months, the remaining six survivors (seven joints) have complete healing with no apparent limitation in the range of motion even after en bloc resection. CONCLUSIONS Most cases of early sternoclavicular joint infections will respond to conservative measures. However, when radiographic evidence of infection beyond the sternoclavicular joint is present, en bloc resection, although seemingly aggressive, results in immediate eradication of all infection with negligible functional morbidity. Prolonged antibiotic therapy or continued local drainage procedures appear to have little value in these cases, adding only to patient care costs and the potential sequelae of chronic infections.
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Affiliation(s)
- G N Carlos
- Indiana University School of Medicine, Department of Surgery, Indianapolis 46202, USA
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Aglas F, Gretler J, Rainer F, Krejs GJ. Sternoclavicular septic arthritis: a rare but serious complication of subclavian venous catheterization. Clin Rheumatol 1994; 13:507-12. [PMID: 7835020 DOI: 10.1007/bf02242953] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Sternoclavicular septic arthritis is a rare complication of subclavian venous catheterization. We estimate that septic involvement of this joint may be as common as one in 500 catheterizations. We report two patients with insidious onset of shoulder pain, chest discomfort, low-grade fever and slight but painful swelling of a sternoclavicular joint four weeks following subclavian venous catheterization. Positive blood cultures in the presence of abnormal bone scan and abnormal conventional X-ray examination or computed tomography of the sternoclavicular joint led to the diagnosis of septic arthritis. Both patients responded well to antibiotic treatment. Based on our observations and that reported in the literature, the earliest changes of sternoclavicular septic arthritis may be detected by bone scan while plain X-ray studies and CT become abnormal during advanced stages of this type of arthritis. We would like to alert physicians to this cause of fever and joint pain in patients who previously underwent subclavian venous catheterization.
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Affiliation(s)
- F Aglas
- Department of Internal Medicine, Karl Franzens University, Graz, Austria
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Chen WS, Wan YL, Lui CC, Lee TY, Wang KC. Extrapleural abscess secondary to infection of the sternoclavicular joint. Report of two cases. J Bone Joint Surg Am 1993; 75:1835-9. [PMID: 8258556 DOI: 10.2106/00004623-199312000-00015] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- W S Chen
- Department of Orthopedic Surgery, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan
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15
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Abstract
A patient receiving home parenteral nutrition developed osteomyelitis of the clavicle associated with a Hickman catheter which had been functioning for 14 months. The infection was treated with bone curettage, parenteral antibiotics, and catheter removal. Although this has been a reported complication of subclavian vein catheters, this is the first reported case associated with a Hickman catheter.
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Affiliation(s)
- A B Kravitz
- Department of Surgery, Medical Center of Delaware, Newark
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Mousa AM, Muhtaseb SA, Al-Mudallal DS, Marafie AA, Habib FM. Brucellar sternoclavicular arthritis, the forgotten complication. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 1988; 82:275-81. [PMID: 3250341 DOI: 10.1080/00034983.1988.11812244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Of 511 cases of brucellosis studied between December 1983 and February 1986, four (0.8%) had sternoclavicular (STCL) arthritis. Two were male and two female, and only one was younger than 50 years old. All four cases had significantly high specific IgG antibody titres (1 of 1280), measured by the indirect immunofluorescent (IIF) test, and two had Brucella melitensis isolated from their blood. In two cases, STCL arthritis was the presenting problem, and it was associated in one with ankle arthritis, hepatitis, renal impairment, orogenital ulcers and a haematological picture of myelodysplasia; in the other it was a relapsing STCL arthritis. In the remaining two cases, STCL arthritis was part of an extensive osteoarticular disease, which was associated in one with cachexia, liver cirrhosis, heart failure and prostatitis with urine retention, and in the other with severe thrombocytopenia. Excellent results were obtained from six to eight weeks' therapy with streptomycin, rifampicin and cotrimoxazole or tetracycline.
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Affiliation(s)
- A M Mousa
- Adan Hospital, Ministry of Public Health, Kuwait
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Lindsey RW, Leach JA. Sternoclavicular osteomyelitis and pyoarthrosis as a complication of subclavian vein catheterization: a case report and review of the literature. Orthopedics 1984; 7:1017-22. [PMID: 24823247 DOI: 10.3928/0147-7447-19840601-18] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Numerous complications have been attributed to subclavian vein catheterization. Osteomyelitis and/or sternoclavicular pyoarthrosis is a rarely mentioned complication, previously reported only four times. Soft tissue infections occur frequently and respond well to topical and antibiotic treatment. If symptoms should persist for several weeks, osteomyelitis and/or sternoclavicular pyoarthrosis should be considered. We advocate management with early surgical intervention. Bone and gallium scans are helpful diagnostically, but CT scans offer the best assessment of the sternoclavicular joint itself. Surgery has produced excellent results, without functional compromise.
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Abstract
Osteomyelitis of the clavicle is rare; however, it may occur following head and neck surgery. Risk factors include radiation, long-standing tracheitis, disruption of the periosteum or the cortical bone with interruption of the blood supply to the clavicle. Proper management includes early diagnosis, surgical debridement of soft tissue and bone, appropriate antimicrobial therapy, and coverage of the defect with a myocutaneous flap to protect the great vessels of the upper mediastinum.
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Klein B, Mittelman M, Katz R, Djaldetti M. Osteomyelitis of both clavicles as a complication of subclavian venipuncture. Chest 1983; 83:143-4. [PMID: 6401239 DOI: 10.1378/chest.83.1.143] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Complications of subclavian vein catheterization are common and include pneumothorax, hemothorax, and sepsis. Osteomyelitis is a rare complication. The present report describes a patient with osteomyelitis of both clavicles due to subclavian vein venipuncture, in whom fever and chills were absent and the sole clinical finding was local pain and tenderness in the involved area.
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Abstract
The proximity of the subclavian vein to several important structures of the arm, neck and chest make serious complications in subclavian catheterization occur in 0.4% to 9.9% of cases. Complications can be in immediate, chronic and late categories. An understanding of the anatomy, venography and a step-by-step technique of catheterization will help prevent complications and assist the physician in recognizing them when they occur.
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Affiliation(s)
- M Westreich
- Department of Surgery, Wayne State University School of Medicine, Detroit, Michigan 48201
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