肩胛骨颈部骨折合并肱骨头脱位的外科治疗

Surgical Management of Scapular Neck Fractures Associated with Dislocation of Humeral Head

目的 探讨肩胛骨颈部骨折合并肱骨头脱位或半脱位的解剖学基础及外科治疗方法。方法 1 992年 7月～ 2 0 0 1年 1 1月收治肩胛骨颈部骨折合并肱骨头脱位或半脱位 7例。骨折部位 :解剖颈骨折 2例 ,其中 1例合并喙突骨折 ;外科颈骨折 5例 ,合并肩胛冈骨折 2例 ,合并体部骨折 1例。 7例中合并肱骨头脱位 1例 ,合并肱骨头半脱位 6例 ,7例均行切开复位 ,钢板螺丝钉内固定术。结果 本组随访时间为 1个月～ 8年 ,7例肩胛骨颈部骨折愈合时间在 6～ 9周。 6例术后功能恢复优良。结论肩胛骨颈部构造特殊 ,手术切开复位内固定适用于不稳定性骨折 。

Objective To discribe the anatomic features and surgical treatment of the scapular neck fractures associated with dislocation of humeral head.Methods The seven cases of the scapular neck fractures associated with dislocation of humeral head were involved in this series.Male in 5 cases and female in 2 cases, average age was 31 8 years.Seven cases of the scapular fractures were located in neck.All of the cases were treated by open reduction and stable fixation.Results We were able to follow up 7 cases,of which 5 cases gave good or excellent results.Conclusion The anatomy of scapular neck is special,the scapular neck fracture types is complex.Operative treatment may,however,be indicated,especially with unstable fractures of the scapular neck associated with dislocation of humeral head,the plate and screw fixation are effective.