Nakamura Yosuke, Gotoh Masafumi, Mitsui Yasuhiro, Shirachi Isao, Yoshikawa Eiichiro, Uryu Takuya, Murakami Hidetaka, Okawa Takahiro, Higuchi Fujio, Shiba Naoto
Department of Orthopaedic Surgery, Kurume University Medical Center.
Kurume Med J. 2015;61(3-4):77-9. doi: 10.2739/kurumemedj.MS64009. Epub 2015 Aug 25.
Rupture of any two or more parts of the superior shoulder suspensory complex (SSSC) including the distal clavicle, acromion, coracoid process, glenoid cavity of the scapula, acromioclavicular ligament, and coracoclavicular ligament is associated with shoulder girdle instability and is an indication for surgery. Here we report a case of acromioclavicular joint dislocation associated with coracoid process fracture. A 48-year-old man sustained a hard blow to the left shoulder from a fall, and simple radiography detected a coracoid process fracture and acromioclavicular joint dislocation. The injury consisted of a rupture of two parts of the SSSC. For the coracoid process fracture, osteosynthesis was performed using hollow cancellous bone screws. For the acromioclavicular joint dislocation, hook plate fixation and the modified Neviaser's procedure were performed. The bone healed well 5 months after surgery, at which time the screws were removed. At 18 months after initial surgery, the coracoid process fracture had healed with a 10% rate of dislocation on radiography, and the patient currently has no problem performing daily activities, no range of motion limitations, and a Japanese Orthopaedic Association scale score of 93.
肩锁上悬吊复合体（SSSC）的任何两个或更多部分断裂，包括锁骨远端、肩峰、喙突、肩胛骨的关节盂、肩锁韧带和喙锁韧带，都与肩胛带不稳定相关，是手术指征。在此我们报告一例肩锁关节脱位合并喙突骨折的病例。一名48岁男性因跌倒时左肩部受到重击，普通X线检查发现喙突骨折和肩锁关节脱位。该损伤包括SSSC的两个部分断裂。对于喙突骨折，采用空心松质骨螺钉进行骨内固定。对于肩锁关节脱位，进行了钩钢板固定和改良的内维亚泽尔手术。术后5个月骨折愈合良好，此时取出螺钉。初次手术后18个月，喙突骨折已愈合，X线检查显示脱位率为10%，患者目前日常生活活动无问题，活动范围无受限，日本骨科协会评分93分。
