鎖骨遠位端骨折に対する肩鎖関節プレートの使用経験

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  • Surgical Treatment for Distal Clavicular Fractures Using an Acromioclavicular Plate

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The purpose of this study was to evaluate the results of surgical treatments for distal clavicular fractures using an acromioclavicular plate. We treated 14 cases of distal clavicular fracture. According to the Craig-Takubo classification, one fracture was Type Ⅱa, five were Type Ⅱb, six were Type V, and one was Type IV. Operations were performed under general anesthesia using an acromioclavicular plate. After surgery, all shoulders were fixed with a sling for one week, and shoulder use under 90 degrees of flexion and abduction was allowed until removal of the plate. In all cases except for one, the acromioclavicular plate was removed within 6 months, and patients performed shoulder exercise on their own. The average period until removal of the acromioclavicular plate was 5.4 months. Bone union was obtained in a cases. There were no cases of refracture after plate removal, and no cut-out of the plate hook at the acromion. The average range of shoulder motion was 170 degrees in flexion and 58 degrees in extended motion. We observed a bone defect at the acromion, which had been created by the hook of the acromioclavicular plate, but this became unclear within 3 months after plate removal. Problems associated with the acromioclavicular plate included limited shoulder motion until plate removal, and persistence of the bone hole in the acromion for several months. The acromioclavicular plate might be a useful internal fixator because of its strong fixation and simplicity of application.

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