不同手术入路治疗肩胛骨体部和盂颈部骨折的效果  

Effects of different surgical approaches for scapular body and glenoid neck fractures

作　　者：胡远军 成瑞萍 王飞 史会明[1] 张志忠[1] HU Yuan-jun;CHENG Rui-ping;WANG Fei;SHI Hui-ming;ZHANG Zhi-zhong(Traumatic Orthopedics Department, Hanzhong Central Hospital, Hanzhong 723000, China)

机构地区：[1]汉中市中心医院创伤骨科

出　　处：《临床医学研究与实践》2019年第24期12-14,共3页Clinical Research and Practice

基　　金：陕西省卫生计生科研基金项目(No.2016C005)

摘　　要：目的 探讨不同手术入路治疗肩胛骨体部和盂颈部骨折的效果.方法 回顾性分析2010年1月至2017年1月105例经手术治疗的肩胛骨体部和盂颈部骨折患者的临床资料,按手术入路不同将其分为A组(21例,Judet入路组)、B组(39例,改良Judet入路组)、C组(17例,反Judet入路组)、D组(28例,肩胛骨外侧缘入路组).比较四组的治疗效果.结果 105例患者平均随访(19.17±5.76)个月,切口均甲级愈合、无切口感染、无延迟愈合或骨折不愈合.四组的切口长度、手术时间、术中失血量及CMS评分比较,差异有统计学意义(P<0.05).A组的CMS评分与B、C及D组比较,差异有统计学意义(P<0.05);B、C及D组的CMS评分两两比较,差异无统计学意义(P>0.05).结论 不稳定性肩胛骨体部和盂颈部骨折手术治疗应综合患者实际情况选择最佳手术入路,以减少术中不必要的剥离和损伤,减少出血量,缩短手术时间.Objective To explore the effects of different surgical approaches for scapular body and glenoid neck frac原 tures. Methods The clinical data of 105 patients with scapular body and glenoid neck fractures who underwent surgical treatment from January 2010 to January 2017 were retrospectively analyzed. The patients were divided into group A (21 cases, Judet approach group), group B (39 cases, modified Judet approach group), group C (17 cases, anti-Judet ap原 proach group), and group D (28 cases, lateral margin of scapula approach group). The therapeutic effects of the four groups were compared. Results The average follow-up time of 105 patients was (19.17依5.76) months. All the incisions were grade A healing, without infection, delayed union or nonunion. There were significant differences in incision length, operation time, intraoperative blood loss and CMS score among the four groups (P<0.05). The CMS score of the group A was signifi原 cantly different from that of the group B, C and D (P<0.05). There were no significant differences in CMS score among the group B, C and D (P>0.05). Conclusion In order to reduce unnecessary dissection, injury and blood loss and shorten opera原 tion time, the optimal surgical approach for unstable scapular body and glenoid neck fractures should be selected according to the actual situation of patients.

关 键 词：肩胛骨 骨折 手术入路 内固定 

分 类 号：R683.41[医药卫生—骨科学]