Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan.
BMC Musculoskelet Disord. 2019 Jul 18;20(1):333. doi: 10.1186/s12891-019-2720-z.
Intraosseous suture-button devices have been used for acromioclavicular joint reconstruction due to its relative simplicity compared with other procedures. However, the complications of acromioclavicular joint reconstruction using a suture-button are not fully understood. Here, we describe a case of a clavicle fracture at the suture hole following acromioclavicular joint reconstruction using a suture-button and hook plate.
A 28-year-old man presented at our hospital after a fall from his bicycle. The patient had a history of acromioclavicular joint reconstruction with a suture-button and a hook plate for right acromioclavicular joint dislocation, seven months ago at another hospital. The hook plate had been removed four months ago, while X-ray radiography before removal had shown the widening of a suture hole. In the current fall from the bicycle, X-ray radiography revealed a clavicle fracture through the previous drill hole for suture-button. We removed the suture-button and performed an open reduction and internal fixation for the clavicle fracture.
The present case indicated that a clavicle fracture at the suture hole, although rare, is one of the complications after an acromioclavicular joint reconstruction using a suture-button. This case suggested that drilling to the necessary minimum when making suture holes and paying attention to the widening of suture holes are important to prevent a postoperative clavicle fracture.
与其他手术相比，骨内缝线纽扣装置在肩锁关节重建中因其相对简单而被广泛应用。然而，缝线纽扣用于肩锁关节重建的并发症尚未完全被了解。在此，我们描述了一例使用缝线纽扣和钩板重建肩锁关节后，缝线孔处锁骨骨折的病例。
一名 28 岁男性因从自行车上摔下就诊于我院。患者 7 个月前在另一医院因右肩锁关节脱位行缝线纽扣和钩板肩锁关节重建术，4 个月前已取出钩板，而取出前 X 射线显示缝线孔增宽。此次从自行车上摔下后，X 射线显示锁骨通过先前缝线纽扣的钻孔处发生骨折。我们取出缝线纽扣，并对锁骨骨折行切开复位内固定术。
本病例表明，使用缝线纽扣重建肩锁关节后，缝线孔处锁骨骨折虽然罕见，但也是一种并发症。该病例提示，缝线孔钻孔时应尽量做到最小化，并注意缝线孔的增宽，这对于防止术后锁骨骨折很重要。
