Yokoyama Yuya, Furuhata Ryogo, Tanji Atsuhi, Fujita Shota
Department of Orthopaedic Surgery, Ashikaga Red Cross Hospital, Ashikaga-shi, Tochigi, Japan.
Trauma Case Rep. 2023 Oct 18;48:100953. doi: 10.1016/j.tcr.2023.100953. eCollection 2023 Dec.
Distal clavicle nonunion is a relatively common complication of unstable, displaced distal clavicle fractures; however, its standard surgical procedure has not been fully established. We describe a case of symptomatic nonunion of a distal clavicle fracture with a very small distal bone fragment that was treated with a scorpion plate. A 63-year-old man presented with left shoulder pain after a bicycle fall 5 months earlier. Plain radiographs and computed tomography revealed atrophic nonunion of the distal clavicle with a small distal bone fragment measuring 12 mm in length. Shoulder pain interfered with his work and daily life; therefore, we scheduled surgery. After releasing the nonunion site, cancellous bone was grafted from the iliac crest. We placed a scorpion plate with two grasping arms that fixed the distal clavicular fragment without straddling the acromioclavicular joint. One year postoperatively, his pain subsided, and bone union was confirmed. Our case presents a surgical procedure for treating the nonunion of distal clavicle fractures using a scorpion plate and an autologous bone graft. This procedure is especially beneficial for cases with small distal bone fragments, because the grasping arms of the scorpion plate allow secure fixation of the distal bone fragment and bone graft without further fragmentation.
锁骨远端骨不连是不稳定、移位的锁骨远端骨折相对常见的并发症；然而，其标准手术方法尚未完全确立。我们描述了一例有症状的锁骨远端骨折骨不连病例，其远端骨块非常小，采用了蝎形钢板进行治疗。一名63岁男性在5个月前骑自行车摔倒后出现左肩疼痛。X线平片和计算机断层扫描显示锁骨远端萎缩性骨不连，远端有一小骨块，长度为12毫米。肩部疼痛影响了他的工作和日常生活；因此，我们安排了手术。在松解骨不连部位后，取自髂嵴的松质骨进行植骨。我们放置了一块带有两个抓持臂的蝎形钢板，该钢板固定锁骨远端骨块，而不跨越肩锁关节。术后一年，他的疼痛缓解，骨愈合得到确认。我们的病例展示了一种使用蝎形钢板和自体骨移植治疗锁骨远端骨折骨不连的手术方法。该方法对于远端骨块较小的病例特别有益，因为蝎形钢板的抓持臂能够牢固固定远端骨块和骨移植，而不会导致进一步碎裂。
