鎖骨近位端骨折の治療経験

概要

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Background: Fracture of the proximal clavicle is relatively rare. There are few reports about their treatments. The purpose of our retrospective study is to report the results and features of the proximal clavicle fractures which were treated in our institution. Methods: This series included 22 cases. There were 11 males and 11 females. The mean age at injurywas 60.8 years old. The mechanism of injury was; falls from height in 12 cases, motor vehicle accident in 5 cases, and simple fall in 5 cases. Twelve cases were complicated by other injuries at the shoulder girdle. Ten cases were not complicated by other trauma lesions . The Robinson classification of fractures was type 1A1 in 8, type1B1 in 11, type1B2 in 3 cases. Results: Conservative treatment was attempted in 10 cases. Operative treatment was attempted in 12 cases. Seven of these ten conservative cases showed evidence of non-union. All cases treated operatively had good results without any hardware complication or non-union. The Robinson classification of the non union fractures was type 1A1 in 4 of 7 cases,(57%) type 1B1 in 2 of 2 cases(100%) and type 1B2 in 1 of 1 cases(100%). All conservative cases with other injuries at the shoulder girdle resulted in non union. Conclusion: We considered type 1B fracture of the proximal clavicle, with any other injuries at the shoulder girdle should be treated operatively. Locking plate is safe hardware in surgical cases.
日本肩関節学会の論文