Klavikula Orta 1/3 Şaft Kırığı Ve İpsilateral Akromioklavikular Eklem Çıkığı: Olgu Sunumu

Yıl 2022, Cilt: 5 Sayı: 3, 232 - 234, 15.10.2022

Bahadır Balkanlı , Cem Copuroglu , Murat Erem

Öz

Klavikula kırıkları klasik olarak kırığın bulunduğu yere göre tanımlanır. Klavikula kırıklarının yaklaşık %80'i orta şaft kırıklarıdır. Akromiyoklaviküler eklem yaralanmaları, klavikula kırıkları gibi benzer travma mekanizmalarından kaynaklanır. İpsilateral akromiyoklaviküler eklem çıkığı ile ilişkili klavikula şaft kırığı, nadir görülen bir yaralanma türüdür. Akromiyoklaviküler Rockwood tip 3 eklem yaralanması ve orta şaft klavikula kırığı ile ilgili literatürde sınırlı sayıda vaka bulunmaktadır. Olgumuzda Rockwood sınıflamasına göre sol klavikulada orta üçüncü klavikula kırığı ve ipsilateral tip 3 AC eklem görünümü saptandı. Rockwood tip 3 akromiyoklaviküler yaralanmaların tedavisi tartışmalıdır. Bizim durumumuzda yeterli stabilizasyonu sağladığımız için bir kilitleme plakası ve tek bir Endobutton sabitleme sistemi (Smith & Nephew) seçtik. Sonuç olarak postoperatif altıncı ayda omuz hareket açıklığı tamdı ve şikayeti yoktu.

Anahtar Kelimeler

akromioklaviküler eklem çıkığı, klavikula kırığı, ipsilateral, orta 1/3 cisim kırığı, cerrahi tedavi

MIDSHAFT CLAVICLE FRACTURE AND IPSILATERAL DISLOCATİON OF THE ACROMIOCLAVICULAR JOINT: A CASE REPORT

Öz

Clavicle fractures are classically defined according to the location of the fracture. Approximately 80% of clavicle fractures are midshaft fractures. Acromioclavicular joint injuries are caused by similar trauma mechanisms such as clavicle fractures. The clavicle shaft fracture associated with the ipsilateral acromioclavicular joint dislocation is a rare type of injury. There are a limited number of cases in the literature of acromioclavicular Rockwood type 3 joint injury and midshaft clavicle fracture. Our case revealed that the left clavicle had a middle third clavicle fracture and an ipsilateral type 3 AC joint appearance according to the Rockwood classification. Management of Rockwood type 3 acromioclavicular injuries is controversial. We have chosen a locking plate and a single Endobutton fixation system (Smith & Nephew) because we provide sufficient stabilization in our case. As a result, in the sixth month postoperatively, the shoulder range of motions was full, and had no complaints.

Anahtar Kelimeler

acromioclavicular joint dislocation, clavicle fractures, ipsilateral, midshaft, surgical treatment

Kaynakça

• 1. Ottomeyer C, Taylor BC, Isaacson M et al. Midshaft clavicle fractures with associated ipsilateral acromioclavicular joint dislocations: Incidence and risk factors. Injury. 2017;48(2):469-473.
• 2. Burnham JM, Kim DC, Kamineni S. Midshaft Clavicle Fractures: A Critical Review. Orthopedics. 2016;39(5):814-821.
• 3. Wurtz LD, Lyons FA, Rockwood CA. Fracture of the middle third of the clavicle and dislocation of the acromioclavicular joint: A report of four cases. J Bone Joint Surg Am. 1992;74:133–137.
• 4. Yeh PC, Miller SR, Cunningham JG et al. Midshaft clavicle fracture and acromioclavicular dislocation: a case report of a rare injury. J Shoulder Elbow Surg. 2009;18(5):1-4.
• 5. Spyridon AP, Olga DS, Sofia MV et al. A rare injury of ipsilateral mid-third clavicle fracture with acromioclavicular joint dislocation. Hand (N.Y.). 2011; 6(2): 228–232.
• 6. Hillen RJ, Burger BJ, Poll RG et al. Malunion after midshaft clavicle fractures in adults. Acta Orthop. 2010;81:273–279.
• 7. Epstein D, Day M, Rokito A. Current concepts in the surgical management of acromioclavicular joint injuries. Bull NYU Hosp Jt Dis. 2012;70:11–24.
• 8. Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med. 2007;35:316–329.
• 9. Lazarides S, Zafiropoulos G. Conservative treatment of fractures at the middle third of the clavicle: the relevance of shortening and clinical outcome. J Shoulder Elbow Surg. 2006;15:191–194.
• 10. Solooki S, Azad A. Smimultaneous middle third clavicle fracture and type 3 acromioclavicular joint dislocation; a case report. Arch Bone Jt Surg. 2014;2(1):69-71.