关节镜下经皮空心螺钉内固定治疗IdebergⅠa型肩胛盂骨折的临床研究

Clinical study of arthroscopic percutaneous hollow screw internal fixation for treatmentof Ideberg typeⅠa glenoid fracture

目的：评估关节镜下经皮空心螺钉内固定治疗IdebergⅠa型肩胛盂骨折的临床效果.方法：回顾性分析我院骨科行关节镜下经皮空心螺钉内固定治疗的7例IdebergⅠa型肩胛盂骨折患者.评估患者术后肩关节活动度、肩关节功能CMS评分和UCLA评分.结果：（1）7例患者术中失血量、手术时间及住院天数平均值分别为8.9±3.2ml、62.8±10.4分钟和8.6±1.3天;患者术后24周肩关节前屈和外旋度数分别达159.7±8.9°和67.5±4.7°,内旋伸拇指平均可达T8±2水平;患者术前和术后24周肩关节功能CMS评分分别为53.7±2.8分和89.6±10.2分,差异具有统计学意义（P〈0.05）,术后24周疗效满意率为85.7%（6/7）;患者术前和术后24周肩关节功能UCLA评分分别为15.5±2.4分和31.6±2.8分,差异具有统计学意义（P〈0.05）,术后24周优良率为85.7%（6/7）.结论：关节镜下经皮空心螺钉内固定是治疗IdebergⅠa型肩胛盂骨折的有效治疗方案,患者肩关节功能恢复满意度高且安全,值得临床上推广选择.

Objective：To evaluate the effect of arthroscopic under the clinical effect of percutaneous hollow screw internal fixation for the treatment of ideberg type Ia scapular glenoid fractures.Methods：A retrospective analysis of our hospital orthopedics with arthroscopic percutaneous cannulated screw internal fixation for the treatment of 7 cases ideberg type Ia scapular glenoid fractures.Evaluation of shoulder joint mobility,shoulder joint function CMS score and UCLA score.Results：1） 7 patients with intraoperative blood loss,operation time and hospitalization days respectively （8.9±3.2）,ml （62.8±10.4） and minutes （8.6±1.3） days;24 weeks after operation in patients with shoulder flexion and external rotation degree respectively （159.7±8.9） and （67.5±4.7）,internal rotation extend thumb up to an average of T8±2 level;preoperative and postoperative 24 week CMS score of the shoulder joint function respectively （53.7±2.8）% and （89.6±10.2）,the difference was statistically significant （P 〉 0.05）,the postoperative satisfaction rate was 24 weeks efficacy 85.7% （6/7）;patients before and 24 weeks after operation,UCLA score of the shoulder joint function respectively （15.5±2.4）% and （31.6±2.8）,the difference was statistically significant （P 〉 0.05）,24 weeks after operation,the excellent rate was 85.7% （6/7）.Conclusion：Arthroscopic by percutaneous hollow screw internal fixation should be effective therapy for treatment of ideberg type Ia scapular glenoid fractures,shoulder joint function recovery of patients with high satisfaction and safety,it might be worth clinical promotion of choice.