手术治疗浮肩损伤的临床疗效

Operative treatment of floating shoulder injury

目的探讨手术治疗浮肩损伤的损伤机制、临床特征和手术方法。方法回顾分析17例浮肩损伤患者手术治疗的临床资料,对7例稳定性浮肩损伤采用锁骨骨折切开复位内固定或锁骨远端骨折钩钢板固定术治疗,对10例不稳定性浮肩损伤施行锁骨骨折切开复位内固定或锁骨远端骨折钩钢板固定术同时施行锁骨骨折及肩胛骨的切开复位内固定术的治疗。结果17例患者均获得随访,随访时间平均11.5个月。全部患者的骨折在预定解剖部位上均复位满意,术后16周内骨折均骨性愈合。Hecscovici的疗效标准,优12例(70.59%),良3例(17.64%),可1例(5.88%),差1例(5.88%),疗效优良率为88.24%。结论手术内固定有利于肩关节早期功能锻炼,减少创伤后冻结肩的发生,也可避免肩部骨骼缩短或突起影响美观,并且有利于伴发损伤的诊治和护理。

Objective To explore the method and result of operative treatment of floating shoulder injery（FSI）. Methods Seventeen cases of FSI were admitted from January 2001 to December 2007. Seven steady FSI cases were treated with internal plate fixation on clavicle. Ten unsteady FSI cases were treated with internal fixation on both scapular neck and clavicle. Results All the cases were followed up, averaged 11.5 months. All the cases got satisfactory replacements and were healed in 16 weeks. Based on Hecscovici＇s standard, 12 cases （70.59%） had excellent results, 3 cases （17.64%） better, 1 case （5.88%） fair, 1 case（5.88%） poor, with good curative effect being 88.24%. Conclusions Internal fixation of operation is beneficial for shoulder＇s exercises earlier and management and nursing of injury reducing the incidence of frozen shoulder. It can also avoid shoulder bones shortening which may affect appearance of patient＇s body.