Sautet Pierre, Galland Alexandre, Airaudi Stéphane, Argenson Jean-Noël, Gravier Renaud
Aix-Marseille université, institut du mouvement et de l'appareil locomoteur, hôpital Sainte-Marguerite, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France.
Institut de la main et du membre supérieur (IMMS), 393, avenue du Prado, 13008 Marseille, France.
Orthop Traumatol Surg Res. 2018 Dec;104(8):1237-1240. doi: 10.1016/j.otsr.2018.07.025. Epub 2018 Nov 2.
Neer IIB displaced fracture of the distal part of the clavicle is often treated surgically. Arthroscopy-assisted surgery was recently developed. The aim of the present study was to present an original technique of subcoracoid suture under arthroscopy, with clinical and radiological results.
Arthroscopy-assisted subcoracoid suture in Neer IIB clavicle fracture provides satisfactory results.
Fourteen patients, with a mean age of 34.6 years (range, 24-51 years) with Neer IIB displaced clavicle fracture treated by subcoracoid suture between January 2013 and January 2017 were included. Clinical assessment comprised demographic data, weighted Constant score and Subjective Shoulder Value (SSV). Radiologic assessment comprised AP shoulder view.
Bone healing was systematic within 3 months, except in 1 case of delayed healing. Mean follow-up was 20 months (range, 6-55 months). At last follow-up, mean weighted Constant score was 91% (range, 85-95%) and mean SSV 95% (range, 85-100%). 4 patients reported clavicle button irritation, 2 of whom asked for hardware removal.
Arthroscopy-assisted subcoracoid suture provided satisfactory clinical results. There were no cases of implant failure, probably because the technique caused no iatrogenic coracoid trauma. Clavicle button irritation sometimes required hardware removal.
IV.
Neer IIB型锁骨远端移位骨折常需手术治疗。关节镜辅助手术是近年来发展起来的。本研究的目的是介绍一种关节镜下喙突下缝合的新技术，并给出临床和影像学结果。
关节镜辅助下喙突下缝合治疗Neer IIB型锁骨骨折可取得满意效果。
纳入2013年1月至2017年1月间采用喙突下缝合治疗的14例Neer IIB型锁骨移位骨折患者，平均年龄34.6岁（范围24 - 51岁）。临床评估包括人口统计学数据、Constant评分加权值和主观肩关节评价值（SSV）。影像学评估包括肩关节前后位片。
除1例延迟愈合外，所有患者均在3个月内实现骨愈合。平均随访时间为20个月（范围6 - 55个月）。末次随访时，Constant评分加权值平均为91%（范围85 - 95%），SSV平均为95%（范围85 - 100%）。4例患者报告有锁骨纽扣刺激症状，其中2例要求取出内固定物。
关节镜辅助下喙突下缝合取得了满意的临床效果。没有出现内固定失败的病例，可能是因为该技术未造成医源性喙突损伤。锁骨纽扣刺激症状有时需要取出内固定物。
IV级。
