Ray Shirsha, Nair Vinod
Orthopaedics, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, IND.
Cureus. 2022 Dec 20;14(12):e32761. doi: 10.7759/cureus.32761. eCollection 2022 Dec.
Clavicle fractures are a common clinical problem that accounts for about 10% of all fractures. Cho's type II fractures compromise the integrity of the coracoclavicular ligament and are thus inherently unstable, necessitating a lengthy healing period and being associated with a high rate of nonunion or malunion. The lowering of these rates is largely dependent on restoring the stability of the distal clavicle. In our case report, a 60-year-old male came to the OPD with complaints of pain over the right shoulder for two days following a fall with his arm in an adducted position. He also complained of an inability to abduct the right shoulder beyond 45 degrees. A plain radiograph was done, which was suggestive of a right lateral end clavicle fracture with increased coracoclavicular distance compared to the uninvolved shoulder. He was taken up for surgery after routine laboratory investigations and pre-anaesthesia check-up and minimally invasive coracoclavicular ligament reconstruction was done using a semitendinosus autograft. Intra-operatively, both the conoid and trapezoid ligaments showed tears. A universal shoulder immobilizer was applied post-surgery and continued for six weeks. Pendular exercises of the shoulder were started as per tolerance, and the patient responded well to surgery.
锁骨骨折是常见的临床问题,约占所有骨折的10%。赵(Cho)氏II型骨折破坏了喙锁韧带的完整性,因此本质上不稳定,需要较长的愈合期,且不愈合或畸形愈合率较高。降低这些发生率很大程度上取决于恢复锁骨远端的稳定性。在我们的病例报告中,一名60岁男性因手臂内收位摔倒后右肩部疼痛两天前来门诊。他还抱怨右肩外展不能超过45度。进行了X线平片检查,结果提示右侧锁骨外侧端骨折,与未受伤侧肩部相比,喙锁距离增加。在进行常规实验室检查和麻醉前检查后,他接受了手术,采用半腱肌自体移植物进行了微创喙锁韧带重建。术中,圆锥韧带和斜方韧带均显示撕裂。术后应用通用肩部固定器并持续六周。根据耐受情况开始进行肩部钟摆运动,患者对手术反应良好。