直切口入路治疗肩胛骨颈部及体部骨折临床效果观察

The clinical effects of straight incision in the treatment of scapular neck and body fractures

目的：评价直切口入路治疗肩胛骨颈部及体部骨折临床疗效。方法选择肩胛骨颈部及体部骨折患者62例，按数字表法随机分为观察组30例和对照组32例，对照组采用传统的Judet入路手术，观察组采用直切口入路手术。观察两组患者手术一般情况、骨折愈合时间、治疗有效情况及术后并发症情况，评价术后患者的关节功能改善情况。结果观察组手术切口大小、手术时间和术中出血量均优于对照组（ t＝9．599、9．506、21.297，均P＜0．01），两组骨折愈合时间差异无统计学意义（t＝0．922，P＝0．35）。观察组骨折愈合有效率为93．3％，高于对照组的71．9％（χ2＝4．885，P＜0．05）。观察组并发症发生率为13．3％，低于对照组的37．5％（χ2＝4．723，P＜0．05）。观察组日常活动评分优于对照组（t＝3．761，P＜0．01）。结论直切口入路较Judet入路手术治疗肩胛骨颈部及体部骨折更具有微创性，对患者的预后更好。

Objective To evaluate the clinical effect of straight incision in the treatment of scapular neck and body fractures .Methods 62 cases with scapular neck and body fractures were randomly divided into the obser -vation group （30 cases） and control group （32 cases）.The control group was given the traditional Judet approach operation,the observation group was given the straight incision operation .The general situation of operation ,fracture healing time ,clinical efficacy and postoperative complications were observed .The improvement of joint function after operation was evaluated .Results The operation incision ,operation time and intraoperative blood loss of the observa-tion group were significantly better than those of the control group （t=9.599,9.506,21.297,P〈0.01）.The fracture healing time between two groups had no statistically significant difference （t=0.922,P=0.35）.The effective rate of fracture healing in the observation group was 93.3%,which was significantly higher than 71.9%of the control group （χ2 =4.885,P〈0.05）.The incidence rate of complication in observation group was 13.3%,which was lower than 37.5%in the control group（χ2 =4.723,P〈0.05）.The score of daily activities in observation group was better than the control group（t=3.761,P〈0.01）.Conclusion The straight incision operation is more minimally invasive in the treatment of scapular neck and body fractures compared with Judet approach ,and it has better prognosis .