抄録
The purpose of this study was to investigate the surgical outcome for distal end fracture of the clavicle. 70 cases had been operated on at Saiseikai Kanagawaken Hospital, Shizuoka City Shimizu Hospital and Shizuoka Red Cross Hospital from 2001 to 2007. These cases were classified according to Craig classification and Takubo's classification type VI. There were 2 cases in type IIa, 46 cases in type IIb, 15 cases in type V, and 7 cases in type VI. The average age at operation was 40.7 years old (19 - 80 years old). The operations contained 52 cases of ACJ plate, 10 cases of tension-band wiring, and 8 cases of Scorpion plate. The mean follow-up period was 9.9 months (5.6 - 19.3 months). The bone union period, stability of acromioclavicular joint, and the displacement rate at fracture site were evaluated on X-ray at final follow-up. The postoperative clinical results were evaluated by the Japan Orthopaedic Association (JOA) shoulder score. In 4 cases (1 case of type IIb and 3 cases of type V), non-union developed. The postoperative JOA scores were 96.2(82 - 100). There were no significant differences in JOA scores among fracture types (p=0.36) and among the operative procedures (p=0.077). The bone union periods did not show significant difference among the operative procedures (p=0.97). Displacement rate at fracture site displayed significantly higher in tension band wiring and Scopion plate group than in ACJ plate group (p=0002). The frequency of acromion-clavicular joint subluxation displayed significantly higher in tension-band wiring and Scopion plate group than in ACJ plate group (p=002). The cases operated on using procedures which did not stabilize the acromionclavicular joint developed acromioclavicular dislocation or displacement at fracture site more frequently. It could be important to stabilize the acromionclavicular joint for a while after operation in order to get a stable acromioclavicular joint.
