不稳定性肩胛骨骨折的手术治疗与入路选择分析

Surgical treatment and approaches for unstable scapular fractures

目的探讨不稳定性肩胛骨骨折的手术治疗及手术入路选择。方法2004年7月～2009年7月治疗不稳定性肩胛骨骨折患者25例,其中开放性骨折取原伤口入路,闭合性骨折分别取肩关节前侧、肩胛骨后侧、肩胛骨外侧缘入路,骨折复位后运用重建钢板、螺钉、钢丝等进行固定。结果所有患者均获随访,随访时间3～20个月,平均11个月。术后复查X线片显示复位满意。根据Hardegger功能评定标准,优18例,良6例,可1例,优良率为96%。结论对不稳定性肩胛骨骨折选择合适的手术入路和固定方法,辅以早期功能锻炼,疗效满意。

Objective To explore surgical treatment and approaches for unstable scapular fractures. Method Twenty-five cases with unstable scapular fractures underwent operations in our hospital from July 2004 to July 2009. The operations were performed through entry of the original wound sites for open fractures and via anterior, posterior, and lateral border approaches for closed fractures. Reconstruction plates, lag screws and steel-wires were used to fix the fractures after reduction. Results All cases had an average follow up time of 11 months （ from 3 to 20 months）. X-ray examination results showed satisfactory postoperative reduction. According to Hardegger＇s evaluation criterion, 18 cases showed excellent results, 6 good and 1 fair with an excellent-to-good rate of 96%. Conclusion Satisfactory results can be achieved by the choices of appropriate approach and reasonable fixation method as well as earlier functional exercises for unstable scapular fractures.