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安全螺钉固定技术治疗喙突基底骨折伴肩锁关节脱位及 CT 轴位扫描测量喙突基底截面积数据

Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study.

机构信息

Department of Orthopedics, Tokushima Red Cross Hospital, 103, Irinokuchi, Komatsushima-cho, Komatsushima, Tokushima, Japan,

出版信息

Arch Orthop Trauma Surg. 2014 Jul;134(7):913-8. doi: 10.1007/s00402-014-1995-7. Epub 2014 Apr 26.

Abstract

Coracoid base fracture accompanied by acromioclavicular joint dislocation with intact coracoclavicular ligaments is a rare injury. Generally, an open reduction with screw fixation is the first treatment choice, as it protects the important structures around the coracoid process. This report presents a new technique of screw fixation for coracoid base fracture and provides anatomic information on cross-sectional size of the coracoid base obtained by computed tomography (CT). An axial image of the coracoid base was visualized over the neck of the scapula, and a guidewire was inserted into this circle under fluoroscopic guidance. The wire was inserted easily into the neck of scapula across the coracoid base fracture with imaging in only 1 plane. In addition, 25 measurements of the coracoid base were made in 25 subjects on axial CT images. Average length of the long and short axes at the thinnest part of the coracoid base was 13.9 ± 2.0 mm (range 10.6-17.0) and 10.5 ± 2.2 mm (6.6-15.1), respectively. This new screw fixation technique and measurement data on the coracoid base may be beneficial for safety screw fixation of coracoid base fracture.

摘要

喙骨基部骨折伴喙锁关节脱位且喙锁韧带完整是一种罕见的损伤。一般来说,切开复位螺钉固定是首选治疗方法,因为它可以保护喙突周围的重要结构。本报告介绍了一种新的喙骨基部骨折螺钉固定技术,并提供了 CT 获得的喙骨基部横截面积的解剖学信息。在肩胛骨颈部上方可视化喙骨基部的轴位图像,并在透视引导下将导丝插入该圆内。仅通过 1 个平面的成像,导丝很容易穿过喙骨基部骨折进入肩胛骨颈部。此外,在 25 名受试者的轴向 CT 图像上对喙骨基部进行了 25 次测量。喙骨基部最薄处的长轴和短轴的平均长度分别为 13.9±2.0mm(范围 10.6-17.0)和 10.5±2.2mm(6.6-15.1)。这种新的螺钉固定技术和喙骨基部的测量数据可能有助于喙骨基部骨折螺钉固定的安全性。

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