鎖骨遠位端骨折の手術治療 ∼ LCP Clavicle Hook Plate ® と tension band wiring の比較

概要

論文の詳細を見る
Background: There are several surgical procedures for distal clavicle fracture, but it's indication is unclear. The purpose of this study is to investigate which is safer and less-invasive, LCP Clavicle Hook Plate ® (Synthes, inc, West Chester, PA.USA), or Tension Band Wiring. Methods: 34 patients who were operated on for distal clavicle fracture, were divided two groups, regardless of fracture type, sex, and age. The 1st group were treated by CHP. The 2nd group were treated by TBW. The average age of CHP group patients was 39 (range, 23-51) years old, and TBW group patients was 43 (range, 21-65) years old. Those cases were classified according to Craig and Takubo's classifications; CHP group: 5 in typeIIa, 6 in typeIIb, 5 in typeV, 1 in typeVI, TBW group: 2 in typeIIa, 8 in typeIIb, 5 in typeV, 1 in typeVI. The mean follow-up period of CHP group was 12.8 (3 ∼ 29) months, TBW group was 14.4 (10 ∼ 25) months. Investigation items were operation time, length of incisions, complications, JOA score, Elevation range. JOA score and elevation range were assessed 3 months after removal surgery. Results: There were no significant differences in operation time, JOA score, or elevation range. Mean incision size of CHP was 9.7 (7 ∼ 12)cm, TBW was 8.3 (6 ∼ 12)cm(P=0.03). Complication rate of CHP was 5.8%, TBW was 29.4%(p=0.06). Conclusion: TBW is less invasive surgery than CHP, but the safer procedure is CHP for unskilled surgeons.