肩胛骨外侧缘入路与标准Judet入路手术治疗肩胛骨骨折的疗效

Curative effect analysis of scapula lateral margin approach and standard Judet approach in the operative treatment of scapular fracture

目的探讨肩胛骨外侧缘入路与标准Judet入路方式治疗肩胛骨骨折的疗效。方法回顾性分析2006年1月至2013年2月48例肩胛骨骨折患者的病例资料,根据手术入路方式分为观察组和对照组,观察组27例采用肩胛骨外侧缘入路手术治疗,对照组21例采用标准Judet入路手术治疗,比较2组临床疗效和并发症发生情况。结果观察组手术时间和术中出血量均少于对照组(P<0.05),骨折愈合时间也短于对照组(P<0.05);术后6个月,观察组优良率高于对照组(P<0.05)。术后观察组患肢日常活动和肌力评分高于对照组,差异均有统计学意义(P<0.05),疼痛评分、关节活动评分组间比较差异无统计学意义(P>0.05)。结论肩胛骨外侧缘入路手术治疗肩胛骨骨折操作简便、并发症少,可作为肩胛骨骨折手术治疗的优选方案。

Objective To compare the effect of scapula lateral margin approach and standard Judet approach in the operative treatment of scapular fracture. Methods Medical data of 48 patients with scapular fractures from January 2006 to February 2013 were retrospectively analyzed. They were divided into the observation group and the control group according to the surgical approach. 27 patients in the observation group were treated with operative treatment through scapula lateral margin approach and 21 patients in the control group were treated with sur- gical treatment through standard Judet approach. Compared the clinical effects and complications of the patients in two groups. Results To operation time and intraoperative hemorrhage in the observation group were less than that of the control group （ P 〈 0.05 ）, fracture healing time was shorter than that of the control group after operation （ P 〈 0.05 ）. Six months after operation, the excellent rate of the observation group was higher than that of the control group. Scores of daily activities and myodynamia in the observation group were higher than that ofthe control group,the differences were statistically significant （P 〈 0. 05 ）, and there was no significant difference in the scores of pain and joint motion between the groups （P 〉 0. 05 ）. Conclusion Scapula lateral margin approach in treatment of scapular fracture has the advanta- ges of easy operation, small trauma, definite effect, little complication and it can be used as the preferred scheme of scapular fracture operative treatment.