烏口突起骨折の治療と分類

抄録

We experienced eight fractures of the coracoid process during the period from 1984 to 1992. Seven cases of them were basal fractures and one case was apical one. Two cases were isolated, being in the other six cases combined with acromioclavicular dislocation or clavicular fracture. One patient with minimally displaced fracture of the coracoid process was treated conservatively. But the others were treated by internal fixation with a cannulated malleolar screw, one of which was inserted percutaneously. Postoperatively, Kenny-Howard type harness was worn in each case for four weeks. The result was satisfactory and all surgical cases were united. Neither infection nor loss of function was observed. These fracutures were assessed regarding the cause of injury, region of contusion, and complicated osseous-articular injuries around the shoulder. From the mechanism of injury, they were classified into two major groups: Group I; direct fracture, group II; indirect fracture. The direct fractures were subdivided into two types: Type I; by force from outside, type II; by force from inside. The indirect fractures were further divided into two types; Type I; by ligamentous traction, type II; by muscular traction. It is recommended to treat operatively if a gap of indirect fracture is five millimeter or more on roentgenograms.