肩鎖関節脱臼に対する烏口肩峰靱帯移行術の治療経験

Clinical Study of Coracoacromial Ligament Transfer for Acromioclavicular Dislocation

　肩鎖関節完全脱臼に対しては一般的に観血的治療が行われる．当院では烏口鎖骨靱帯再建を目的として烏口肩峰靱帯を肩峰付着部で切離・移行し，靱帯のみをBunnel法にて鎖骨に縫着する術式を行っている．12例の成績は川部らの評価法で優8例，良4例であり，文献にみられる骨片付きで靱帯を移行する術式と本法の間に再脱臼率の差はなかった．本法は自覚的にも他覚的にも満足度の高い成績であり，有用であると考えられた．

　Complete dislocation of the acromioclavicular joint should be treated surgically. In our procedure the coracoacromial ligament is detached from the acromion with no bone fragment attached, and the ligament itself is transferred and fixed to the clavicle by Bunnel suture to reconstruct the coracoclavicular ligament. This procedure was used to treat 12 patients, and according to their Kawabe scores the outcome was excellent in 8 patients and good in 4. There was no significant difference between the redislocation rate according to whether the procedure was performed with a fragment of bone attached or not. Both the subjective and objective results were satisfactory, and we concluded that this procedure is sufficiently effective.