肩鎖関節脱臼を伴う烏口突起骨折の治療

概要

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A coracoid process fracture with an acromioclavicular joint (AC-j) dislocation is a comparatively rare injury. The purpose of this study was to evaluate the therapeutic results for this injury. We treated 12 patients (all male) with a mean age of 45 (24 to 82). Two patients were treated conservative. On the other patients, the surgery was performed with screws for a coracoid process fracture; additionally we used K-wire (6 cases) or Wolter-Clavicular plate (4 cases) for an AC-j fixation. We evaluated the therapeutic results more than 6 months post injury using the Japan Shoulder Society AC-j score. In all cases who underwent the surgery, a bone union was accomplished without infection and breakage of the hardware. Postoperative subluxation of the AC-j was recognized in 3 patients. One of them needed the resection of the distal end of the clavicle for severe pain caused by osteoarthritis of the AC-j. Excluding this case, there was no patient who recognized the AC-j pain or subcoracoid impingement. The AC-j score was a mean 93 points (81 to 100 points). On the other hand, pain remained in 2 patients treated conservatively, and one of them got a no-union. The AC-j scores were 50 and 52 points. In the surgical treatment for a coracoid process fracture with an AC-j dislocation, it was possible to obtain satisfactory therapeutic results. However, the patients treated conservatively obtained poor results.
日本肩関節学会の論文