不稳定肩胛骨骨折的手术治疗  

Surgical Treatment of Unstable Scapular Fracture

作　　者：叶永平[1] 符臣学[1] 徐皓[1] 钟继平[1] 

机构地区：[1]南京军区福州总医院骨科,福建福州350025

出　　处：《实用骨科杂志》2005年第2期135-137,共3页Journal of Practical Orthopaedics

摘　　要：目的　探讨肩胛骨不稳定骨折的手术治疗。方法　随访分析1999年1月至2 0 0 4年1月收治的经手术治疗的16例不稳定肩胛骨骨折患者,根据Hardegger分类方法,肩胛盂窝骨折4例、解剖颈骨折6例、外科颈骨折4例、粉碎性骨折2例。结果　16例患者有12例获得完整随访资料,随访时间3个月～4年,平均2 1月,采用Hardegger肩关节功能评定标准,优4例,良6例,可2例。优良率83.3% ,平均骨折临床愈合时间8周。结论　a)不稳定肩胛骨骨折畸形愈合严重影响肩关节功能,需行手术切开复位内固定治疗。b)对肩胛骨骨折治疗前需要进行全面的X线摄片检查和CT检查,以全面了解骨折情况,判断骨折的稳定性及有无手术指征。c)对有手术指征的不稳定肩胛骨骨折应根据不同骨折的部位和形态,选择相应的手术入路和内固定物进行手术治疗。Objective To discuss the surgical treatment of unstable scapular fracture. Methods 16 cases with scapular fracture that admitted to our hospital were treated by surgical operation from January 1999 to January 2004. There were 4 fractures of glenoid fossa,6 fractures of anatomical neck, 4 fractures of surgical neck, 2 cases of smash fracture. Results 12 cases of 16 were followed up for 3 months to 4 years, According to Hardegger evaluation, 4 cases showed excellent results, 6 good, 2 fair, The average clinical healing time last for 8 weeks. Conclusion a)Abnormal healing of unstable scapular fracture will affect the function of shoulder severely. b)Before treatment of scapular fracture,the patients should be examined by X-ray and CT scan to judge the stability and surgical indication. c)The unstable scapular fracture with surgical indication should be treated by different surgical entry and internal fixation according to different type of fracture.

关 键 词：肩胛骨骨折 手术治疗 切开复位内固定治疗 2004年1月 功能评定标准 骨折畸形愈合 X线摄片检查 不稳定骨折 1999年 外科颈骨折 粉碎性骨折 肩关节功能 无手术指征 分类方法 骨折患者 随访分析 随访时间 随访资料 愈合时间 

分 类 号：R683.41[医药卫生—骨科学] R684.7[医药卫生—外科学]