Surgical management of XXXX .

@entity1 @entity558 @entity55 @entity794 @entity281 @entity158 @entity221 @entity130
OBJECTIVE: @entity281 are rare, and their management is controversial. We reviewed our experience with the surgical management of this condition. METHODS: From August 1988 to August 2001, 26 @entity1 (16 @entity1 and 10 @entity1 ) were treated surgically for @entity281 . The median age was 56 years (range, 20-77 years). @entity1 who had a recent previous median sternotomy were excluded. RESULTS: All @entity1 were symptomatic. @entity158 was present in 21 @entity1 , swelling in 14 @entity1 , @entity221 in 11 @entity1 , and erythema in 9 @entity1 . @entity558 included @entity281 in other areas in 12 @entity1 ( @entity55 in 4 @entity1 , @entity281 in 2 @entity1 , and other in 6 @entity1 ) and an indwelling central venous catheter in 1 @entity1 . Five @entity1 had a history of @entity130 in the region of the joint. Four @entity1 had prior joint incision and drainage. Unilateral sternoclavicular joint resection was done in 18 @entity1 , bilateral resection in 2 @entity1 , and incision and drainage with debridement in 6 @entity1 . Wound culture results were positive in 24 @entity1 , and the most common organism isolated was @entity794 (n = 17). Eleven @entity1 had transposition of the ipsilateral pectoralis major muscle to obliterate residual space and to reconstruct the chest wall. Two (7.7%) @entity1 had complications, and 1 died (operative mortality, 3.8%). Follow-up was complete in all 25 operative survivors and ranged from 2 months to 10 years (median, 25 months). Twenty-one @entity1 are alive without symptoms, @entity281 , or limitations in range of motion. Four @entity1 have died as a result of causes unrelated to their joint @entity281 . CONCLUSIONS: Symptomatic @entity281 often require surgical intervention. Surgical resection combined with muscle transposition provides effective long-term outcome.
