后侧微创入路内固定技术对肩胛骨骨折患者应用价值  

Application value of posterior minimally invasive internal fixation technique in patients with scapular fractures

作　　者：朱纪辉[1] 张磊 陈国庆 杨永良 王浩[2] ZHU Jihui;ZHANG Lei;CHEN Guoqing;YANG Yongliang;WANg Hao(Department of Trauma Orthopedics,Changqing District People's Hospital,Jinan,Shandong 250300,China;Department of Orthopedics,Shandong Provincial Hospital,Jinan,Shandong 250021,China)

机构地区：[1]济南市长清区人民医院骨科,山东济南250300 [2]山东省立医院创伤骨科,山东济南250021

出　　处：《社区医学杂志》2024年第18期632-636,共5页Journal Of Community Medicine

摘　　要：目的探讨肩胛骨骨折患者治疗中后侧微创入路内固定技术的应用价值。方法回顾性分析2018-08-01-2022-02-25长清区人民医院骨科(25例)及山东省立医院创伤骨科(15例)诊治的40例肩胛骨骨折患者的临床资料,依据内固定技术入路分为后侧微创入路组(观察组)、Judet传统入路组(对照组)各20例。统计分析2组患者围手术期指标、肩关节活动度、疼痛程度、臂肩手功能障碍、肩关节功能、日常生活能力、临床疗效、术后并发症发生情况和切口周围皮肤外观满意度。结果观察组患者的切口长度(11.30±2.44)cm,短于对照组(28.02±4.51)cm,t=14.582,P<0.001;术中出血量(100.02±9.44)mL,少于对照组(420.03±9.12)mL,t=109.031,P<0.001;手术时间(86.42±11.45)min,短于对照组(120.56±9.86)min,t=14.290,P<0.001;骨折愈合时间(10.02±1.06)周,短于对照组(12.02±2.14)周,t=5.297,P<0.001。根据手术前基线数据调整,手术后2组患者的肩关节外展、外旋、水平内收、屈曲活动度均高于手术前,且观察组患者上述指标活动度均高于对照组,F值分别为11.200、11.028、12.211和12.139,均P<0.001。手术后,2组患者的视觉模拟评分法(VAS)评分、臂肩手功能障碍(DASH)评分均低于手术前,Constant肩关节评分、日常生活能力量表(ADL)评分均高于手术前,观察组患者的VAS评分、DASH评分均低于对照组,Constant评分、ADL评分均高于对照组,F值分别为13.690、10.310、18.135和3.331,均P<0.001。观察组患者的肩关节功能恢复优良率为95.00%(19/20),高于对照组的75.00%(15/20),χ^(2)=6.275,P=0.012。观察组患者的术后并发症发生率为5.00%(1/20),低于对照组的20.00%(4/20),χ^(2)=4.114,P=0.043。观察组患者的切口周围皮肤外观满意度为95.00%(19/20),高于对照组的70.00%(14/20),χ^(2)=8.658,P=0.003。结论肩胛骨骨折患者治疗中后侧微创入路内固定技术的应用效果优于Judet传统入路内固定术,可改善围手术期指标、�Objective To explore the application value of minimally invasive posterior approach internal fixation technology in the treatment of patients with scapular fractures.Methods A retrospective analysis was conducted on the clinical data of 40patients with scapular fractures treated in the Orthopedics Department of Changqing District People's Hospital(25 cases)and the Trauma Orthopedics Department of Shandong Provincial Hospital(15cases)from August 1,2018to February 25,2022.According to the internal fixation technique approach,the patients were divided into a posterior minimally invasive approach group(observation group)and a Judet traditional approach group(control group),with 20cases in each group.Statistical analysis of perioperative indicators,shoulder joint mobility,pain level,arm shoulder hand dysfunction,shoulder joint function,daily living ability,clinical efficacy,incidence of postoperative complications,and satisfaction with the appearance of the skin around the incision in two groups of patients.Results The incision length of the observation group patients was(11.30±2.44)cm,which was shorter than that of the control group(28.02±4.51)cm,t=14.582,P<0.001.The intraoperative blood loss was(100.02±9.44)ml,which was less than that of the control group(420.03±9.12)ml,t=109.031,P<0.001.The operation time was(86.42±11.45)minutes,which was shorter than the control group's(120.56±9.86)minutes,t=14.290,P<0.001.The fracture healing time was(10.02±1.06)weeks,which was shorter than the control group's(12.02±2.14)week,t=5.297,P<0.001.After adjusting for baseline data before surgery,the shoulder joint abduction,external rotation,horizontal adduction,and flexion range of motion of both groups of patients were higher than before surgery,and the observation group had higher range of motion than the control group,with F-values of 11.200,11.028,12.211,and 12.139,respectively,all P<0.001.After surgery,the visual analogue scale(VAS)scores and disability of arm shoulder and hand(DASH)scores were lower in both groups of pat

关 键 词：肩胛骨骨折 Judet传统入路 后侧微创入路 内固定技术 肩关节活动度 肩关节功能 

分 类 号：R687.3[医药卫生—骨科学]