浮肩损伤的外科治疗(附19例报告)

Surgical Treatment of Floating Shoulder Injury in 19 Cases

目的探讨浮肩损伤的临床特征及治疗方法。方法回顾分析2000年4月至2006年7月收治的.经手术治疗的19例浮肩损伤患者的临床资料。患者均有不同程度的合并损伤,其中肋骨骨折、血气胸和(或)肺挫伤占89.5%。受伤至手术时间3～42 d,平均10.2 d。术后3个月对患者肩关节功能根据Herscovici标准进行评定,并对浮肩损伤的临床特征和治疗进行总结。结果术后随访3-50个月,平均16.2个月。肩胛颈骨折在目标区上均获解剖复位,锁骨和肩胛,目'均愈合。根据Herscovici标准进行评定,优15例(78.9%),良3例(15.8%),可1例(5-3%)。结论浮肩损伤多南高能量直接暴力所致,常伴有合并损伤。切开复位内同定能恢复肩关节的动力平衡及稳定性.可早期进行功能锻炼.是一种较好的治疗方法。

Objective To explore clinical feature and surgical treatment of the floating shoulder injury （FSI）. Methods A total of 19 patients with floating shoulder injuries were treated in our hospital by operation from April 2000 to July 2006. All cases were accompanied with other injuries, including rib fractures combined hemopneumothorax and/or lung contusion was 89.5%. The mean time from primary injury to perform operation was 10.2 days （ranged 3 to 42 days ）. Three months after operation, the results were evaluated according to the shoulder function scoring system of Herscovici. Results All fractures had been restored anatomical reduction in the target site. The fractures of the clavicle and the scapular neck were union. The mean followed up time was 16.2 months （ranged 3 to 50 months）. According to shoulder function scoring system of Herscovici, 15 （15.8%） cases classified the results as excellent, 3 （15.8%） as good, 1 （5.3%） as fair. Conclusion FSI is often caused by direct high-energy violence and has a high incidence of serious asociated injuries. Open reduction and plate fixation reconstruction is a good treatment method for FSI. It can keep the stability and the balance of shoulder joint and is helpful for early functional exercise and recovery of the shoulder joint.