西藏地区复杂肩胛骨骨折手术治疗疗效分析  

Clinical outcome of complex scapular fracture treated by open reduction and internal fixation in Tibet area

作　　者：马小刚[1] 秦桂兰[1] 缪嘉吉 Xiaogang Ma;Guilan Qin;Jiaji Miao(Department of Orthopedics,Tibet Autonomous Region People's Hospital,Lhasa 850000,China)

机构地区：[1]西藏自治区人民医院骨科,拉萨850000

出　　处：《中华肩肘外科电子杂志》2023年第2期117-121,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的探讨西藏地区肩胛骨骨折的特点和手术治疗效果。方法自2018年9月至2021年11月,对西藏自治区人民医院骨科41例复杂粉碎性肩胛骨骨折患者的临床资料进行分析,其中伴涉及锁骨骨折、肩锁关节脱位14例,肩胛骨颈部、关节盂粉碎性骨折15例,肩胛骨体部粉碎骨折伴局部塌陷12例。合并损伤有多发性肋骨骨折、血气胸、肺挫伤28例,合并颈椎骨折7例,合并脑挫伤6例。对符合手术指征患者进行切开复位内固定治疗,观察术后骨折愈合情况和上肢功能评定表(disabilities of the arm,shoulder and hand,DASH)。结果41例患者均接受手术治疗,获得完整随访,平均随访时间18个月(6~31个月)。术后切口均一期愈合。术后3例患者肩胛体部部分骨不愈合。患侧肩部、臂部肌肉无萎缩。肩关节功能恢复良好。DASH评分平均为7.8分(4~21分)。结论西藏地区肩胛骨粉碎性骨折合并严重复合伤手术治疗能取得良好的治疗效果。Background Scapular fractures occur frequently when the body is subjected to high-energy injury,and the incidence is low,accounting for 0.4%-1%of the total body fractures.Fractures often involve the scapula,neck,glenoid,coracoid,and acromion and are associated with other injuries ranging from 76%to 100%,such as ipsilateral clavicle,ribs,lung contusion,and craniocranial injury.The treatment of comminuted scapular fractures can be tricky.Improper treatment will likely cause many complications,such as glenohumeral instability,glenohumeral arthritis,scapular chest wall motion disorder,shoulder pain,etc.With the increasing demand of patients for upper limb function,surgical treatment of scapular fractures has attracted people's attention.Surgical treatment of glenoid and acromial fractures,unstable coracoid and acromion fractures,and significantly displaced scapular neck and body fractures is a standard clinical option.Currently,doctors in the Tibet region also use surgical methods for open reduction and internal fixation treatment of the above complex scapular fractures.Tibet is located in a high-altitude area with low pressure and low oxygen environment.Do these environmental characteristics affect the treatment of scapular fractures?We used"scapular fracture"and"plateau region"for literature searches in domestic journals,but there were no relevant reports.Objective To explore the characteristics of scapular fracture and analyze the therapeutic effect of open reduction and internal fixation of scapular fracture in the Tibet area.Methods From September 2018 to December 2021,41 cases of comminuted scapular fracture were treated in the department of Orthopedics,People's Hospital of Tibet Autonomous Region,including 32 males and 9 females,with an average age of 42.1(21-60)years.Thirteen patients suffered from traffic accidents,17 patients from heavy crashes,and 11 patients from falling from height.Preoperative imaging examinations including scapular AP view and lateral view were performed to evaluate the ipsilateral sho

关 键 词：西藏地区 肩胛骨粉碎骨折 手术内固定 术后康复 

分 类 号：R687.3[医药卫生—骨科学]