浮肩损伤植入物固定方案选择与骨折移位的关系  

Relationship between implant fixation and fracture displacement after floating shoulder injury

作　　者：曹耀威[1] 余国荣[1] 余黎[1] 江良波[1] 郭永春[1] 赵星[2] 

机构地区：[1]武汉大学中南医院创伤修复骨科,湖北省武汉市430071 [2]武汉大学医学部,湖北省武汉市430071

出　　处：《中国组织工程研究》2016年第9期1329-1335,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:近年来关于浮肩损伤的文献报道逐渐增多,但其治疗上存在明显争议,保守治疗还是手术治疗浮肩损伤是一个迫切需要解决的临床课题。目的:综述浮肩损伤的临床特点和治疗现状。方法:计算机检索PubM ed数据库和中国期刊全文数据库(CNKI)发表于1975年1月至2015年8月有关浮肩损伤治疗的相关研究文献,检索关键词分别"floating shoulder injury,diagnose,treatment method"和"浮肩损伤,诊断,治疗方法",排除发表时间较早的文献或重复研究。共保留33篇文献做进一步分析。结果与结论:(1)浮肩损伤是一种高能量暴力导致的肩关节上悬吊复合体双重损伤的严重肩部损伤,常合并严重的全身多部位损伤,临床上应高度重视。(2)浮肩损伤的治疗一直存在争议,尚未有标准治疗指南。虽然浮肩损伤的保守治疗和手术治疗均能取得较好效果,但近年来保守治疗的报道鲜见,保守治疗可能逊色于手术修复治疗的临床效果。(3)骨折无移位或微小移位可采用保守或单纯锁骨固定治疗,骨折移位明显单纯锁骨固定或锁骨肩胛骨双固定可能取得更好的修复效果。BACKGROUND： There are more literature reports about the floating shoulder injury in recent years, but there still have obvious controversies about the treatment of the floating shoulder injury. Whether choose the conservative treatment or operative treatment is an important issue in face of every clinician. OBJECTIVE： To review the clinical features and present treatment situation of the floating shoulder injury. METHODS： A computer-based online search was performed in the Pub Med and the China National Knowledge Infrastructure database for the clinical research papers on the treatment methods of the floating shoulder injury from January 1975 to August 2015. The key words were floating shoulder injury, diagnose, treatment method. The articles published earlier and repetitive researches were excluded. Finally, 33 articles were included for further analysis. RESULTS AND CONCLUSION：（1） Floating shoulder injury is a kind of severe shoulder injury which is caused by high energy and violence. It is often complicated with severe systemic injury, which should be paid more attention in clinic.（2） The treatment of floating shoulder injury has been controversial, and there is no standard treatment guideline. Conservative treatment and operative treatment can get good outcomes. There are less reports about conservative treatment of the floating shoulder injury in recent years. The outcome of operative treatment may better than conservative treatment.（3） Conservative or simple clavicle fixation can be used for fractures without displacement or with small displacement. Obviously displaced fractures can be treated with simple clavicle fixation or double fixation of clavicle and scapula, which may have good repair effects.

关 键 词：肩胛骨 锁骨 骨折 内固定器 组织工程 骨科植入物 骨植入物 浮肩损伤 漂浮肩 肩胛骨锁骨骨折 肩关节上方悬吊复合体 保守治疗 手术治疗 

分 类 号：R318[医药卫生—生物医学工程]