重建接骨板结合空心螺钉治疗经肩胛盂的肩胛骨骨折  

Treatment of scapular fracture of trans-glenoid with reconstructed plate and hollow screw

作　　者：衡立松[1] 杨佳瑞 何晓[3] 熊晨 黄伟 樊伟 宋哲[1] 朱养均[1] 张堃[1] Heng Lisong;Yang Jiarui;He Xiao;Xiong Chen;Huang Wei;Fan Wei;Song Zhe;Zhu Yangjun;Zhang Kun(Department of Upper Extremity Ward of Orthopaedics and Traumatology,Honghui Hospital,Xi’an Jiaotong University,Xi’an 710054,China;Xi’an Medical College,Xi’an 710068,China;Yan’an University,Yan’an,Shanxi 716000,China)

机构地区：[1]西安交通大学医学院附属红会医院创伤骨科上肢病区,西安710054 [2]西安医学院,西安710068 [3]延安大学,陕西延安716000

出　　处：《创伤外科杂志》2021年第2期110-113,共4页Journal of Traumatic Surgery

基　　金：陕西省社会发展基金项目(2017SF-197);西安市社会发展基金项目[20YXYJ004(8)]。

摘　　要：目的探讨应用重建接骨板结合空心螺钉治疗经肩胛盂肩胛骨骨折的效果。方法回顾性分析2017年10月—2019年5月西安交通大学医学院附属红会医院创伤骨科采用重建接骨板结合空心螺钉治疗经肩胛盂的肩胛骨骨折患者21例,男性13例,女性8例,年龄28~58岁,平均39.7岁。其中重物砸伤10例,道路交通伤6例,高处坠落伤5例,均为闭合性骨折。患者均采用肩胛骨后方经典Judet入路,使用重建接骨板结合空心螺钉固定。末次随访时采用Hardegger肩关节功能评价标准进行评价。结果21例患者术后获9~18个月(平均12.8个月)随访。骨折均获骨性愈合,愈合时间6~15周,平均11.8周。根据Hardegger评价标准评定疗效:优17例,良2例,可1例,差1例,优良率为90.5%。患者均无伤口深部感染和神经血管损伤,1例出现肩关节僵硬。结论应用重建接骨板及空心螺钉治疗经肩胛盂的肩胛骨骨折,可以有效复位及固定,避免肩关节僵硬及创伤性肩关节炎,临床疗效满意。Objective To explore the clinical efficacy of reconstruction plate combined with cannulated screws for the treatment of trans-glenoid scapular fractures.Methods A retrospective analysis was conducted in 21 patients with trans-glenoid scapular fractures who were treated in Department of Upper Extremity Ward of Orthopaedics and Traumatology,Honghui Hospital,Xi’an Jiaotong University from Oct.2017 to May 2019.There were 13 males and 8 females,with a mean age of 39.7 years(28-58 years).There were 10 cases of heavy object-crash injuries,6 cases of road traffic injuries,and 5 cases of falling from height.All the patients had closed fractures and were treated with reconstruction plate and cannulated screws via the classical Judet approach.At the final follow-up,the function of the shoulder was evaluated with Hardegger evaluation standard.Results All the patients were followed-up for 9-18 months,with an average of 12.8 months.All the patients obtained bony union within 6 to 15 weeks(average,11.8 weeks).At the final follow-up,according to the Hardegger evaluation standard,17 cases were excellent,2 cases were good,1 case was fair,and 1 case was poor.The excellent and good rate was 90.5%.None of the patients had deep wound infection or neurovascular injury,and 1 patient showed shoulder stiffness.Conclusion Reconstruction plate and cannulated screws is an effective method for the treatment of trans-glenoid scapular fractures.The reduction and fixation are effective,the shoulder stiffness and traumatic arthritis can be avoided,and patients are satisfied with the clinical effect.

关 键 词：肩胛骨骨折 内固定 接骨板 空心螺钉 

分 类 号：R687.3[医药卫生—骨科学]