Nanno Mitsuhiko, Sawaizumi Takuya, Ito Hiromoto
Department of Orthopaedic Surgery, Nippon Medical School, Musashikosugi Hospital, Nakahara-ku, Kawasaki, Japan.
J Orthop Surg (Hong Kong). 2012 Aug;20(2):246-9. doi: 10.1177/230949901202000223.
We report a 38-year-old man with a combination of fractures in his left shoulder involving the middle and distal clavicle, the scapular neck, and the coracoid process, associated with scapulothoracic dissociation and an upper brachial plexus injury. The middle clavicular fracture was fixed with a plate, whereas the distal clavicular fracture was fixed with tension band wiring. Internal fixation for fractures of the scapular neck and coracoid process was not performed, as they were in an acceptable position after fixation of the clavicular fractures. At the 14-month follow-up, the range of motion of the left elbow, the wrist, and all fingers had recovered fully, whereas that of the left shoulder was limited to 35º abduction, 20º flexion, and 20º external rotation. The strength of the left shoulder abduction, flexion, and external rotation was M2. Elbow flexion, wrist extension, and finger extension strength had recovered to normal (M5). Sensation corresponding to the C5-6 dermatome had also improved to almost normal.
我们报告了一名38岁男性，其左肩存在多处骨折，累及锁骨中段和远端、肩胛颈及喙突，同时伴有肩胛胸壁分离和臂丛上干损伤。锁骨中段骨折采用钢板固定，而锁骨远端骨折采用张力带钢丝固定。肩胛颈和喙突骨折未进行内固定，因为在锁骨骨折固定后它们处于可接受的位置。在14个月的随访中，左肘、腕关节及所有手指的活动范围已完全恢复，而左肩的活动范围限制为外展35°、前屈20°和外旋20°。左肩外展、前屈和外旋力量为M2级。肘屈曲、腕伸展和手指伸展力量已恢复正常（M5级）。对应于C5 - 6皮节的感觉也已改善至几乎正常。
