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

TL;DR

A 21-year-old woman with a clavicle tumor underwent successful reconstruction using a fibular head graft and 3D/MR technology.

Contribution

A novel case of sternoclavicular joint reconstruction using an autologous fibular head with 3D and mixed reality guidance.

Findings

The fibular head graft provided a satisfactory cosmetic and functional outcome.

3D reconstruction and MR technology enabled precise preoperative planning and successful resection.

The patient experienced complete pain relief and improved shoulder function at one-year follow-up.

Abstract

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.

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