鎖骨遠位端骨折に対する tension band wiring 法の成績
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概要
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The purpose of this study was to evaluate the results of tension-band wiring technique for type 2 fractures of the distal clavicle. From 1991 to 2000, 19 consecutive Type 2 fractures of the distal clavicle were treated with the tension-band wiring technique using two Kirschner wires. The average age of the patients was 45.4 years old (range 14 - 73). There were 12 males and 7 females and the average follow-up period was 2 years and 4 months (range 7months - 6years and 5months). All the shoulders were assessed retrospectively, and scored using the JOA shoulder scoring system. Eighteen fractures eventually achieved union and one had a non-union. One case of non-union was asymptomatic. At the final follow-up, the average JOA score was 94.7 (range 60.5 -100) and only one case with an ipsilateral rotator cuff tear showed poor results. Five shoulders had some pain in the acromioclavicular joint, and 4 of them had acromioclavicular subluxations radiographically. Five shoulders showed subluxations of the acromioclavicular joints radiographically and 4 of them were symptomatic. Six shoulders had loss of active flexion and 4 of them had acromioclavicular subluxations. Distal migration of Kirschner wire had occurred in 7 of 19 patients and 4 of them required removal of the hardware early in the postoperative period, but the migration of Kirschner wires were not correlated with the final JOA scores. Tension-band wiring has the advantage of sufficient fixation for a Type2 fracture of the distal clavicle. However in our series, it may be problem that some cases had acromioclavicular subluxations with pain and loss of shoulder flexion.
- 日本肩関節学会の論文
- 2002-01-01
著者
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