腋窝入路与胸大肌三角肌入路手术治疗累及肩胛盂的肩胛骨骨折的疗效比较  

Comparison of effect between axillary approach and pectoralis major deltoid approach in the surgical treatment of scapular fractures involving the glenoid

作　　者：孙志煌 江建[1] 徐佳佳 刘光炜 张辉[1] 李健[1] 张宪彧 吴进 吴国保 SUN Zhi-huang;JIANG Jian;XU Jia-jia;LIU Guang-wei;ZHANG Hui;LI Jian;ZHANG Xian-yu;WU Jin;WU Guo-bao(Department of Orthopaedic,The People's Hospital of Shangrao City,Shangrao,Jiangxi 334000,China)

机构地区：[1]上饶市人民医院(南昌大学附属上饶医院)骨科,江西334000

出　　处：《中国骨与关节损伤杂志》2022年第5期472-475,共4页Chinese Journal of Bone and Joint Injury

基　　金：南京军区科技创新重点课题(15ZD029)。

摘　　要：目的比较腋窝入路与胸大肌三角肌入路手术治疗累及肩胛盂的肩胛骨骨折的临床疗效。方法回顾性分析自2017-09—2019-09诊治的37例肩胛骨骨折,15例采用腋窝入路手术治疗(腋窝入路组),22例采用胸大肌三角肌入路手术治疗(胸大肌三角肌入路组),比较两组手术时间、术中出血量、住院时间、切口长度以及末次随访时的临床疗效。结果两组均顺利完成手术并获得完整随访,随访时间12~18个月,平均15.2个月。末次随访时骨折均愈合,骨折愈合时间2~6个月,平均3.2个月。腋窝入路组手术时间、术中出血量、住院时间较胸大肌三角肌入路组少,切口长度较胸大肌三角肌入路组小,差异有统计学意义(P<0.05)。术后胸大肌三角肌入路组出现1例腋神经损伤,予以对症处理后症状好转。末次随访时腋窝入路组疗效优良率较胸大肌三角肌入路组高,差异有统计学意义(P<0.05)。结论腋窝入路手术治疗累及肩胛盂的肩胛骨骨折具有切口小、隐蔽性强、术中出血量少、手术时间短、疗效稳定等优势,值得进一步推广应用。ObjectiveTo compare the clinical efficacy of the axillary approach and the pectoralis deltoid approach in the surgical treatment of scapular fractures involving the glenoid.MethodsA retrospective analysis of 37 cases of scapular fractures diagnosed and treated from September 2017 to September 2019 was performed,15 cases were treated by axillary approach(axillary approach group),and 22 cases were treated by pectoralis major deltoid approach(deltoid approach group).The operation time,intraoperative blood loss,hospital stay,incision length,and clinical efficacy at the last follow-up were compared between the two groups.ResultsBoth groups were completed the operation successfully and obtained complete follow-up.The followup time was 12-18 months,with an average of 15.2 months.All fractures healed at the last follow-up,and the fracture healing time was 2 to 6 months,with an average of 3.2 months.Compared with the pectoralis major deltoid approach group,the operation time,intraoperative blood loss,and hospital stay as well as the incision length in the axillary approach group were shorter,and the differences were statistically significant(P<0.05).There was 1 case of axillary nerve injury in the pectoralis major deltoid approach group after operation,and the symptoms improved after symptomatic treatment.At the last follow-up,the excellent and good rate of the axillary approach group was higher than that of the pectoralis major deltoid approach group,and the difference was statistically significant(P<0.05).ConclusionThe axillary approach in the surgical treatment of scapular fractures involving the glenoid has the advantages of small incision,high concealment,less intraoperative blood loss,short operation time,and stable curative effect,and is worthy of further promotion and application.

关 键 词：肩胛骨骨折 肩胛盂 腋窝入路手术 胸大肌三角肌入路手术 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]