手术治疗肩胛骨骨折23例疗效分析  

Surgical treatment of scapular fractures in 23 cases

作　　者：郭清河[1] 陈爱民[1] 叶添文[1] 李钧[1] 朱清华[1] 杨迪[1] 江曦[1] 鹿楠[1] 顾春红[1] 翁月红[1] 

机构地区：[1]上海长征医院骨科,上海200003

出　　处：《临床骨科杂志》2011年第6期666-668,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨手术治疗肩胛骨骨折的内固定方式及其疗效。方法手术治疗23例肩胛骨骨折患者,14例采用后方Judet入路,2例采用前后方联合入路,1例喙突骨折与2例盂部前方骨折采用前方入路,2例肩峰骨折采用骨折处直接切开,2例盂部后方骨折采用后方肩胛骨外缘直接切开。16例伴有肩胛骨多处骨折采用钢板螺钉固定,1例喙突骨折及2例关节盂骨折采用拉力螺钉固定,2例肩峰骨折分别采用克氏针和钢丝环扎,2例关节盂骨折采用可吸收螺钉固定。结果 21例获得随访,时间9～55个月。骨折均愈合。采用体格检查及肩关节Constant评分标准进行疗效评价:优11例,良7例,可2例,差1例。术后并发浅表感染1例,外展>90°时轻微疼痛2例,肩胛上神经卡压1例。结论对于达到手术指征的肩胛骨骨折,适合的手术入路及内固定可以达到满意治疗效果。Objective To investigate the fixation styles and effect of surgical treatment of scapular fractures.Methods 23 patients with scapular fractures were treated by open reduction and internal fixation including Judet approach in 14 cases,anterior and posterior approach in 2 cases,anterior approach of coracoid fracture in 1 case and anterior glenoid fractures in 2 cases,direct incision in 2 cases of acromion fracture,posterior direct incision of lateral border scapular in 2 cases of glenoid fractures.16 cases of mixed fracture were fixed by plate,1 case of coracoid fracture and 2 cases of glenoid fractures were used by lag screws,2 cases of the acromion fracture were respectively used by Kirschner wire and cerclage wire,2 cases of glenoid fractures were fixed by bioabsorbable screws.Results 21 patients were followed up duration that extended from 9 to 55 months.The effect outcome were evaluated by Constant score system and physical examination.11 patients showed excellent,7 showed good,2 showed fair,1 showed poor.1 case occurred postoperative superficial infection,and 2 cases complained mild pain when outreach >90°,1 case occurred suprascapular nerve entrapment.Conclusions Scapular fractures with indications can achieve satisfactory outcome by the appropriate approaches and internal fixations.

关 键 词：肩胛骨骨折 入路 骨折固定术 内 

分 类 号：R68[医药卫生—骨科学]