Modified osteotomy for sternoclavicular graft harvest in temporomandibular joint ankylosis patients: A technical note

Abstract

Purpose: Sternoclavicular grafts are considered structurally, histologically and functionally most similar to the temporomandibular joint (TMJ). The technique of split thickness sternoclavicular graft employing the superior segment of clavicle has remain unchanged despite the occurrence of adverse events in the intra-operative and post-operative period. The aim of this technical note is to describe a modified approach for sternoclavicular graft harvest and the advantages of its use. Methods: Two patients with TMJ ankylosis underwent ramus condyle unit reconstruction (RCU) with sternoclavicular grafts harvested using this modified technique. The incidence of clavicle fracture, neurovascular injury, pleural rupture, and radiographic healing as demonstrated on the chest radiograph taken six months after surgery were each evaluated as donor site consequences. Results: Using the current harvesting technique, no adverse events occurred in the intra-operative and post-operative periods. Conclusion: The results of the present study suggest that the modified harvest technique is a useful and straight-forward method and constitutes a new alternative for the TMJ ankylosis patients requiring reconstruction with sternoclavicular grafts after osteoarthrectomy. (Trial registration number (TRN) with Clinical Trials Registry-India CTRI: REF/2024/01/078456 and date of registration: 29/01/2024; Retrospectively registered)