鎖骨遠位端骨折に対する新分類とSCORPION <SUP>®</SUP> の術後成績
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概要
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<B>Background:</B> When performing osteosynthesis using the SCORPION <SUP>®</SUP> (SP), the difficulty of the surgery is difference in the same Craig's classification typeIIB. We have created a new classification for the treatment of SP. The purpose of this study is to evaluate clinical results of plate fixation using SP for unstable distal clavicle fractures.<BR><B>Methods:</B> 61 patients had osteosynthesis performed using SP from 2005 to 2011, and were observed for more than six months after surgery. There were 50 males and 11 females. The mean age was 43.7 (17-90) years old. According to our original classification (typeUII:rhomboid ligament attachment part is separated as a third bone from the distal bone fragment. typeUI:not separated), 29 fractures were classified as typeUI and 32 as typeUII. We checked radiographic results and Japanese Orthopaedic Association (JOA) score.<BR><B>Results:</B> All patients showed bone union. The average JOA score was 97.4 pts (80-100), typeUI(98.3pts), typeUII(96.6pts). The so-called difficult-to-treat cases of typeUII had almost the same good results when compared to the typeUI. Three cases (two cases of elderly people and one case of rotator cuff tear) scored less than 85 pts.<BR><B>Conclusion:</B> Osteosynthesis of distal clavicle fractures using SP was a useful procedure. It is particularly important to get the coracoclavicular stability. In typeUII, the key to successful surgery is that a third fragment attached to the rhomboid ligament is fixed securely by SP hook and high-strength suture.
- 日本肩関節学会の論文
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