2012 年 36 巻 3 号 p. 889-892
Background: We used Scorpion plate (Ai medic) together with functional reconstruction of coracoclaviclar ligament to treat distal end fracture of clavicle with osteoporosis. The purpose of this study was to investigate the surgical outcome.
Materials and methods: Ten cases (8 new and 2 old) were treated by this technique. The average age was 56 years old (19-94 years old).We reviewed the fracture type (Craig classification), union period, complications and postoperative results (JOA score). We split triangular muscle on the base of coracoid process and inserted an anchor into coracoid process in 6 cases. We ran two anchor sutures around the clavicle through the conoid and trapezoid ligaments. Then we put Scorpion plate on the clavicle and tied the suture on the plate. Remaining ligaments were sutured directly in another 4 cases.
Results: There were 5 cases in type IIb, 5 cases in type V. The average union period was 13 weeks in new cases and 18 weeks in old cases. It showed upward displacement of the proximate bone in 2 cases and prolonged union in 2 cases. The average postoperative JOA score was 97 points.
Conclusion: We recognize distal end fracture classified in type II a, II b, V as "Double disruptions of Superior Shoulder Suspensory Complex" that Goss reported. In case of a more unstable fracture, it is important to reconstruct not only the bone fracture, but also the function of coracoclaviclar ligament. Our method makes it possible to produce the static (by plate) and dynamic (by suture) hold.