摘要
背景:肩胛骨骨折发生率逐年增高,对于移位较大的肩胛骨骨折,保守治疗往往存在骨折畸形愈合、肩周疼痛等问题。目的:探讨重建接骨板固定肩胛骨骨折的手术方式及临床疗效。方法:2011年8月至2014年9月共收治肩胛骨骨折患者34例,男28例,女6例;年龄24-67岁,平均(36.4±5.4)岁。按肩胛骨骨折Hardegger分型:肩胛体骨折27处,肩胛颈骨折15处,肩峰骨折1处,肩胛骨骨折4处,盂缘骨折2处,喙突骨折1处,盂窝骨折1处。术前Constant肩关节评分为12.0-25.6分,平均(18.7±6.4)分。受伤至手术时间为3-11 d,平均(6.4±1.1)d。记录患者并发症发生情况及末次随访Constant肩关节评分。结果:34例患者术后获11-17个月随访,平均(12.4±1.2)个月。骨折愈合时间为7-12周,平均(8.0±0.7)周,无伤口感染及愈合不良,无内固定断裂、松动、骨折不愈合及神经血管损伤等并发症发生。按照Constant肩关节评分标准评价患肩功能较术前显著改善,Constant评分为78.5-95.0分,平均(89.0±3.2)分(P<0.05)。结论:重建接骨板治疗肩胛骨颈部及体部骨折可以获得良好复位,术后近期期肩关节功能良好。
Background:The incidence of the scapular fracture has been increased year by year. Conservative treatment of-ten results in malunion and shoulder pain for large injury. Objective:To discuss the operation method and clinical outcomes of reconstruction plate fixation for scapular fracture. Methods:From August 2011 to September 2014, 34 patients with scap-ular fractures were treated. There were 28 males and 6 females with an average age of (36.4±5.4) years (range, 24-67 years). According to the Hardegger classification:scapular body fracture in 27 cases, scapular neck fracture in 15, acromion frac-ture in 1, spine of scapula fracture in 4, glenoid rim fracture in 2, fracture of coracoid process in 1, and glenoid fossa frac-ture in 1. Preoperative Constant shoulder score was 18.7 ± 6.4 (range, 12.0-25.6). The mean period from injury to surgery was (6.4 ± 1.1) d (range, 3-11 d). The incidence of complications and the Constant shoulder score were recorded at the last follow-up. Results:All the 34 patients were followed up for (12.4±1.2) months on average (range, 11-17 months). The mean healing time was (8.0±0.7) weeks (range, 7-12 weeks). No wound infection, poor healing, broken internal fixation, loosen-ing, nonunion or nerve-vascular injuries occurred. Shoulder function was obviously improved according to the results of Constant shoulder score, and the mean Constant score was 89.0±3.2 (range, 78.5-95.0, P〈0.05). Conclusions:Scapular neck and body fractures treated with the reconstruction plate fixation can obtain good reduction and good short-termfunction of the shoulder joint.
出处
《中国骨与关节外科》
2016年第1期40-43,共4页
Chinese Journal of Bone and Joint Surgery
基金
国家自然科学基金青年基金(81501052)
关键词
肩胛骨
骨折
内固定器
Scapula
Fractures,Bone
Internal Fixators