肩鎖関節症に対する鏡視下鎖骨遠位端切除の 2 例 ∼ 術式の工夫
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Resection of the distal clavicle has remained the gold standard for acromioclavicular joint disease. We report two cases of arthroscopic resection of the distal clavicle for acromioclavicular joint pathology.<BR>In the first case a 58 year old man complained of right shoulder pain which had not been reduced by conservative treatment at another hospital. X-ray showed acromioclavicular joint osteoarthritis and MRI showed imcomplete tears of the rotator cuff. Arthroscopic rotator cuff repair and resection of the distal clavicle (6mm) was performed. In the second case a 76 year old woman complained of serious pain and limitation of ROM in the right shoulder from 2 months previously. X-ray showed upward movement of humeral head and MRI showed massive tears of the rotator cuff and effusion of the acromioclavicular joint. There was soft tissue mass continuously at the acromioclavicular joint, with a low signal on T1 and a high signal on T2, 2.0cm×1.5cm in size. Arthroscopic resection of the distal clavicle (10mm) with concomitant subacromial decompression and synovectomy was performed. During the resection, we found a flow of yellow fluid.<BR>We performed arthroscopic resection of the distal clavicle for acromioclavicular joint pathology in two cases and got good results.<BR>We thought that the volume of the resection should not exceed 10mm. Neviaser portal was useful to approach the acromioclavicular joint. We used Codman chisel diameter for the decision of the width of the resection.
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