鎖骨遠位端骨折に対する LCP clavicle hook plate の治療成績

概要

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The purpose is to evaluate postoperative results of a surgical treatment for distal clavicle fractures utilizing the LCP clavicle hook plate (Synthes, inc, West Chester, PA.USA). Seven consecutive patients with fractures of the distal clavicle were treated using CHP. The average age of the patients was 45 (range, 25-67) years old. The mean follow-up period was 11 (range, 7-16) months. Those cases were classified according to Craig classifications; 1 in type I, 1 in type II a, 3 in type II b, and 2 in type VI, respectively. The clinical evaluation was performed using JOA score and the period of the bone fusion. In addition, 3D-CT was performed to determine the subacromial area where CHP was set in the depth or the distance of the bone erosion from the center of the AC joint. The mean JOA score was 95.4 points (range, 90-98) postoperatively. Average period of bony union was 5 months (range, 4-6) radiographically. Two patients suffered from delayed union or cut-out of the acromion. In 3DCT findings, all cases showed bone erosion under the surface of the acromion. Furthermore, the more posterior the position the CHP was set toward, the deeper the bone erosion we detected. (p<0.05, Spearmans rank correction). The data here indicated that the CHP should be set toward the more anterior position beneath the acromion, and reconstructed coracoclavicular ligaments.