鎖骨遠位端骨折及び肩鎖関節脱臼に対する

抄録

(Purpose) We surgically treated the fractures of distal clavicle (7 cases) and dislocation of the acromioclavicular joint (14 cases) with Wolter clavicular plates. The short-term results were good, and we will report the details here.
(Subjects and methods) we operated on seven patients with type II fracture of the distal clavicle (Neer's classification). They were five men and two women whose age ranged from 19 to 75 years with an average of 52.9. The injuries were caused by traffic accidents (4 cases), simple falls (2 cases), and a sports injury (1 case).
The mean follow-up period was one year. We also treated 14 patients with type III dislocation of the acromioclavicular joint (Tossy's classification). They were 13 men and woman whose age ranged from 20 to 74 years with an average 41.6. The injuries were caused by traffic accidents (6 cases), simple falls (4 cases), industrial accidents (2 cases), and sports injuries (2 cases). The mean follow-up period was 9 months. In 12 of the 14 cases, the coracoacromial ligament with its bony attachment was resected from the coracoid process, and fixed to the clavicle by an AO-screw according to Neviaser's technique. (Results) In fractures of the distal clavicle, the range motion of the shoulder after the operation was slightly limited; flexion ranged from 125°to 180°with an average of 159°, whereas abduction ranged from 120°to 180°with an average of 157°. In dislocation of the acromioclavicular joint, the range of motion of the shoulder after the operation was comparatively good; flexion and abduction ranged from 120°to180°with an average of 163°. None of the patients(21)had any postoperative weakness, but four of them complained of painful shoulder motion due to a protrusion of the hook part.18 of the 21 cases had a score of over 90 points on the JOA list.