鎖骨骨幹部骨折に対する前下方プレートの治療成績- 従来法との比較 -

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Midshaft clavicle fractures treated by open reduction and internal fixation with superior plating using 3.5mm reconstruction plates and anteroinferior plating using 3.5mm LC-LCP plates were analyzed by retrospective study. From April, 2006 to March, 2010, twenty-four patients with midshaft clavicle fractures were treated with plating and followed at least until bone union in our institution. Twelve patients (Group S) were treated with superior plating, other patients (Group A) were treated with anteroinferior plating. There was not a statistically significant difference between these two groups about age, sex, injured side, AO fracture classification, combined fracture of the scapula, period from injury to operation, autogenous bone graft, operation time, bone union period, and incidence of various complications. Bone union was finally obtained with all patients, but two failure of fixation were observed in Group S. One was failure of plate but healed without salvage operation and another case was back out of lateral screws and was treated by anteroinferior plating with autogenous bone graft. In all, in thirteen patients (four of Group S, nine of Group A) evaluated by computed tomography at postoperative three months, union was already obtained. Anteroinferior plating is the method using clavicular specific shape; even strong plates such as 3.5-mm LC-LCP plate can be bent to clavicular contour, screws with enough length can be applied to the lateral part of a clavicle, and it is not necessary to do the dangerous procedure of using a drill towards the chest. Because there was no case of failure of fixation in Group A, the potential that anteroinferior locking compression plating was equal to superior conventional plating was suggested.

鎖骨骨幹部骨折に対する前下方プレートの治療成績- 従来法との比較 -

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