肩鎖関節脱臼, Rockwood 分類TypeVの治療成績

The purpose of this study was to compare clinical results of surgical treatment and conservative treatment for acromio-clavi-cular dislocation with a Type V according to Rockwood's classification.<BR>Fifteen patients were diagnosed as Type V acromio-clavicular dislocation. Con-servative treatment was performed in six patients, and surgical treatment in nine. The mean age at the time of injury was forty-eight point eight years-old in conservative treatment group, and thirty-nine point nine years-old in surgical treatment group. A mean follow-up period was twenty-seven point eight months in conservative treatment group, and seven-teen point three months in surgical tre-atment group. In conservative treatment, the range of motion exercises were initiated after fixation of the sling for a short term. In the surgical treatment, after the reposition and internal fixation according to Bosworth's method, the coraco-clavicular ligament was sutured in three patients. After Kirschner's wire fixation of the acromio-clavicular joint, the coraco-clavicular ligament was re-constructed by the transfer of the coraco-acromial ligament in six patients. The clinical evaluations were done acc-ording to the JOA scores. The average JOA score was 69.9 points in conservative treatment group and 91.2 points in surgical treatment group. The average scores of pain were 21.7 points in conservative treatment group and 28.3 points in surgical treatment group. The average scores of function were 19.3 points in conservative treatment group and 19.6 points in surgical treatment group. The average scores of ROM were 27 points in conservative treatment group and 28.1 points in surgical treatment group. Total JOA and pain score were statistically significant difference between conser-vative treatment group and surgical trea-tment group. The results of operative treatment for acromio-clavicular dislocation with Rockwood's type V were sat-isfactory in evaluative pain compared with conservative treatment, but clinical re-sults needed a longer follow-up.