鎖骨外側端骨折（ Neer 分類 type 2 ）に対する鏡視下手術の小経験

概要

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Background: Distal clavicle fractures are divided into three types according to Neer's classification. Type 1 and 3 fractures are treated with a sling. However, the treatment of type 2 fractures is controversial. We paid attention to the anatomic basis of type 2 fractures where the disruptions of the conoid ligament lead to the distraction between the two bony fragments. In this study, we describe the arthroscopic procedure to reconstruct the disrupted ligament and stabilize the fracture as a minimally invasive method. Methods: The subjects were 7 patients with distal clavicle fractures. Our surgical procedure was performed with the patient in the beach chair position. We used the artificial ligament with an EndoButton as the substitute ligament to reconstruct the disrupted conoid ligament. The mean duration of postoperative follow-up was 1 year and 5 months. Results: Bony union was achieved in all patients at final follow-up. Concerning the range of motion at final examinations, mean forward flexion was 171 degrees, mean abduction was 165 degrees, mean internal rotation was Th11, and mean horizontal adduction was 132 degrees. Conclusion: It is possible to treat distal clavicle fractures by a minimally invasive arthroscopic procedure without opening the fracture site of the clavicle.