抄録
A 41-year-old male bicycle racer was injured in a race and diagnosed with a distal clavicle fracture (Neer type II). Two days after the injury, his formerdoctor performed that tension band wiring operation. Following surgery and after he started bicycle training, displacement of the Kirschner wire and dislocation at the fracture site were observed. He was then referred to our hospital, where surgery was carried out. Under general anesthesia, the Kirschner wire was extracted and the region of malunion was scraped. After grafting cancellous bone from the iliac bone, the fracture site was fixed with a BEST acromioclavicular joint plate. Elevation of 90° was prohibited after surgery. But, the patient wanted to do bicycle training before returning to the races. Seven weeks after surgery, under local anesthesia, we separated and removed the hook that fixed the plate to the acromioclavicular joint. Elevation up to 135° was possible two weeks after removal of the hook. He started simulation races after three weeks, and returned to racing after six weeks. At five months after the plate fixation surgery, elevation had increased to 170°, and there was almost no difference in the range of motion between the left and right shoulder joints.
In the treatment of a Neer’s type II distal clavicle fracture in athletes, including professional bicycle racers, strong internal fixation is necessary for early sports rehabilitation. However, when an acromioclavicular joint plate with a hook is used, it is necessary to restrict elevation to 90° before the plate is removed, and consequently it takes a long time to return to the original sport. In the present case, removing only the hook part of the joint plate at around two months after surgery has allowed early return to the original sport.
