PMC7691679_01
Erythema and swelling over the right SCJ with sinus discharging pus.
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After two weeks, the patient was referred to our hospital with erythema and swelling over the right SCJ with sinus discharging pus (Fig. 1).
Computerized Tomography (CT) of the chest showed fluid collection surrounding the right sternoclavicular joint together with joint effusion. Erosive changes of the medial end of the clavicle and upper sternum suggestive of SCJ osteomyelitis.
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Tomography (CT) of the chest showed fluid collection surrounding the right SCJ together with joint effusion. There were also erosive changes of the clavicle's medial end and upper sternum suggestive of SCJ osteomyelitis (Fig. 2).
The initial debridement of the infected and necrotic materials at the right SCJ.
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The patient underwent initial debridement of the infected and necrotic materials at the right SCJ (Fig. 3).
(a) PMF was performed to cover the expected gap after resection. (b) Dissection of the posterior part of the SCJ from the mediastinal structure was performed with special attention to the right subclavian vein. The resultant defect was bounded by the cut end of the clavicle (white arrow), the manubrium (black arrow), and the 2nd rib (arrowhead). (c) The right SCJ and the attached bony freed bony structures were removed en-block.
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Pectoralis major Muscle Flap (PMF) was performed to cover the expected gap after resection (Fig. 4a). Dissection of the posterior part of the SCJ from the mediastinal structure was performed with special attention to the right subclavian vein (Fig. 4b). The right SCJ and the attached bony freed bony structures were removed en-block (Fig. 4c).