不安定型鎖骨遠位端骨折に対する烏口鎖骨靱帯再建術

Reconstruction of the Coracoclavicular Ligament for Unstable Distal Fractures of the Clavicle

　われわれは烏口鎖骨靱帯(CCL)断裂を伴う不安定型鎖骨遠位端骨折に対して，人工靱帯と金属ボタンを用いてCCLを再建する手術法を，1999年以降24例に施行した．追跡期間は平均16カ月であった．骨癒合は，術後3週から重労働に復帰した1例を除いた23例，96％に得られた．軽度の肩関節の可動域制限が2例に認められた．肩関節痛を訴える症例が6例にあった．うち2例に軽度のADL障害を来したが，残りの22例にはADL障害はなかった．以上の結果から，不安定型鎖骨遠位端骨折に対するCCL再建術は有用な手術法と考える．

　Since1999, we have performed coracoclavicular ligament (CCL) reconstruction with an artificial ligament and two metal buttons to treat 24 cases of unstable distal clavicle fracture accompanied by CCL rupture.　The mean follow-up period has been 16 months.　In 23 of the cases bony union was achieved in 2 to 3 months.　Slight range of motion restriction remained in two cases.　Six patients complained of mild shoulder joint pain, and it caused slight impairment of activities of daily living (ADL) in two of them.　There was no interference with ADL in the other 22 cases.　Based on the above results, CCL reconstruction is concluded to be a useful surgical procedure for the treatment of the unstable distal clavicle fractures.