钛网与重建钢板治疗不稳定型粉碎性肩胛骨体部骨折的比较研究

Comparative Study of Treatment of Unstable Comminuted Scapular Body Fracture

目的探讨一种治疗严重粉碎型肩胛骨骨折的新的内固定方式。方法对随访半年以上且资料完整的38例(40肩)不稳定型粉碎性肩胛骨体部骨折进行回顾性研究,其中22例(24肩)为钛网组,16例(16肩)为钢板组。结果 38例均获随访,随访时间6～24个月,平均11.5个月,术后功能锻炼时间、肩关节活动功能、解剖复位率和并发症发生率比较,钛网组优于钢板组,差异有统计学意义(P<0.05);而骨折愈合时间两组差异无统计学意义(P>0.05)。结论采用钛网治疗不稳定型粉碎性肩胛骨体部骨折的临床疗效明显优于重建钢板,具有肩关节功能恢复好,骨折解剖复位率高,术后无需外固定,功能锻炼早,并发症少等优点,是治疗不稳定型粉碎型肩胛骨体部骨折较为理想的选择。

Objective To explore a new fixation method to treat severe comminuted scapular fracture. Methods Thirty eight patients （40 shoulders） with unstable comminuted scapular body fractures with the follow-up more than six months and complete data were studied retrospectively, including 24 for the titanium mesh shoulder fixation group, 16 shoulders for the reconstruction plate fixation group. Results Thirty eight patients were followed up for 6 to 24 months, average 11.5 months, postoperative functional exercise time, shoulder mobility, anatomic reattachment rate and complication rate were compared between titanium mesh group and the reconstruction plate group. The difference was statistically significant （P 〈0.05）; the time of fracture healing between the two groups was not significant （P 〉0.05）. Conclusion The treatment of titanium mesh for unstable eomminuted scapular body fracture is significantly better than reconstruction plates, with good functional recovery of shoulder, anatomical reduction rate, no postoperative external fixation, functional training early, less complications , is the ideal treatment of unstable comminuted fracture of scapular body.