肩甲窩骨折の鏡視下骨接合術に METREx ダイレーターを応用した 1 例

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For treatment of a large anterior glenoid fracture, we present a comparatively easy and unique technique for arthroscopic reduction and internal screw fixation. A 75-year-old woman fell down in a motorcycle accident. The patient felt dislocation and spontaneous reduction of her shoulder. Plane radiograph films showed anterior glenoid fracture with displaced bone fragment. The fragment size measured 35% of the glenoid length by 3DCT images. Fifteen days after the injury the patient was admitted for arthroscopy. The procedure was performed in the beach chair position. The image intensifier was positioned cranially. The arthroscope was introduced through the posterior portal. Mobilization and reduction of the glenoid fragment was performed through the antero-superior portal. In the use of an antero-inferior transsubscapularis approach we applied dilators of METRx MicroDiscectomy System (Medtronic SOFAMOR DANEC). First, a 1.2mm K-wire was inserted through the subscapularis percutaneously and first and second dilators were inserted over the K-wire. Next, the second dilator was removed, then a 7.0mm smooth cannular(Smith & Nephew) in the same diameter as the second dilator was replaced. For fragment fixation TORX 3.0mm cannulated and self-tapping screw (Meira) was used through the cannular. She got bone union in three months after the operation. There were no complications with the operation. We introduce a little contrivance of arthroscopic reduction and internal fixation for an anterior glenoid fracture this time. This method is effective because of being a comparatively easy, safe and minimally invasive surgery.

肩甲窩骨折の鏡視下骨接合術に METREx ダイレーターを応用した 1 例

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