肩甲骨骨折を伴う肩鎖関節脱臼あるいは鎖骨遠位端骨折の治療経験

抄録

[Purpose] Over a period of 8 years, acromioclavicular(A-C)-hook plate was used in 8 patients of A-C dislocations (or distal clavicle fractures) which had accompanying scapular fractures. We have evaluated of functional outcome of their shoulders.
[Material and methods] Six male and 2 female with a mean age of 42.1 years old (range,11-61 years old). Six had acromioclavicular dislocations and 2 cases had distal clavicle fractures. Five had associated coracoid process fractures,2 cases; acromion fractures,1 case; scapular neck fracture,1 case; intraarticular glenoid fossa fracture, and 1 case; a scapular body fracture. There were two very rare cases, which combined injury of acromion fracture with coracoid process fracture and A-C dislocation. Their were followed up after surgery an average of 7.7 months. They were evaluated according to the JOA shoulder score and Kawabe's A-C joint score.
[Results] The mean JOA score was 97.6 points (range,95-100 points) and their mean Kawabe's A-C joint score was 95.6 points (range,90-100 points). The reduction of A-C joint were anatomical or excessive in all the patients.
[Conclusion]A number of reports have shown the significant benefits of surgical treatment for the AC dislocation associated with the fracture of the coracoid process. In the cases of unstable coracoid process fracture, both the A-C dislocation and the coracoid process fracture should be stabilized surgically. We conclude that the utilization of A-C hook plate is a preferred method for the management of A-C dislocations associated with scapular fracture.