改良Judet切口治疗肩胛骨MillerⅡ～Ⅳ型骨折分析  

Treatment of Miller's Type Ⅱ ～ Ⅳ Scapula Fracture with Modified Judet Approach

作　　者：唐文[1] 高辉[1] 赖光松[1] 杨亚东[1] 张飞[1] 刘氜[1] 魏晓军[1] 

机构地区：[1]赣南医学院第一附属医院骨科,江西赣州341000

出　　处：《赣南医学院学报》2015年第6期933-935,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的：探讨经改良Judet切口手术治疗MillerⅡ-Ⅳ型肩胛骨骨折的方法和效果。方法：回顾性分析20例肩胛骨骨折患者。病例分为两组,治疗组9例,采用改良Judet入路作为手术切口,对照组11例,采用经典的Judet切口治疗,记录两组手术时间、术中出血量、术后并发症、术前术后VAS疼痛评分、术后Mallet肩关节功能评分、骨折愈合时间。结果：20例均获随访。两组对比：手术时间治疗组少于对照组;术中出血量治疗组少于对照组;术前两组VAS疼痛评分无明显差别,术后3个月VAS疼痛评分治疗组略优于较对照组;骨折均在3.5-6个月愈合,骨折愈合时间治疗组与对照组无明显差异;术后Mallet肩关节功能随时间持续好转,但两组无明显差异,末次随访评分均达优等。治疗组术后并发症少于对照组。结论：改良Judet入路可充分显露肩胛骨骨折,具有对切口内的组织损伤小,并发症少的优点,有利于术后肩关节功能的恢复。Objective： To explore the outcome of the treatment of Millerg type Ⅱ-Ⅳ scapula fracture with modified Ju- det approach. Methods： 20 patients with Millerg type Ⅱ-Ⅳ scapular fractures were undergone surgical fixation in our hospital. The outcome were retrospectively analyzed. Among them, 9 patients were treated via the modified Judet approach as the treatment group, the other 11 patients were treated via the classic Jude approach as control group. The operation time, blood loss, complications , VAS scale, time cost for bone union, and Mallet scale of preoperative and postoperative were recorded. Results： All the 20 patients have been followed up. The operation time, blood loss and complications of the treatment group were less than those of the control group. There had no significant differences between two groups about the preoperative VAS scale, but the treatment group＇s outcome were more satisfied then the control group 3month after operation. There had no differences between the two groups for time cost of bone union and Mallet scale of shoulder joint postoperative. Conclusion： The modified Judet approach allows a good visualisation for the Millerg type Ⅱ-Ⅳ scapula fractures, facilitating the reduction and safe internal fixation of dislocated scapular fractures. It makes lesser soft tissue damage and complications.

关 键 词：肩胛骨骨折 内固定 改良Jude入路 

分 类 号：R683.41[医药卫生—骨科学]