The classification of scapular fractures and the efficacy analysis of minimally invasive surgical approach
-
摘要: 目的：探讨微创切口治疗肩胛骨骨折的适应证及疗效。方法：2004-02-2012本院17例肩胛骨骨折的病例纳入本研究。17例患者中，男性15例，女性2例，年龄范围为19~75岁，平均年龄为39岁。其中，肩胛盂骨折9例，肩胛骨突起部位骨折3例，肩胛骨体部骨折5例；车祸伤8例，高处坠落伤5例，直接暴力伤2例，刀砍伤2例；闭合性骨折14例，开放性骨折3例。根据Hard egger的分型方法[1]，体部骨折6处，肩胛冈骨折5例，肩胛颈骨折2处，盂缘骨折2处，盂窝骨折2处。其中混合型骨折10例，合并全身发伤5例。通过微创切口入路手术，对不同类型的肩胛骨骨折使用重建钢板或拉力螺钉和钢丝等固定。结果：17例患者获得随访，随访时间6月~3年，平均18个月。根据Rowe疗效评价标准，优11例，良2例，可2例，差2例，优良率83.7%。术后并发肩关节创伤性关节炎2例。结论：经微创切口入路内固定肩胛骨骨折操作简单，暴露较充分，效果可靠。除了肩胛骨体部粉粹性骨折外及漂浮肩外，几乎各类型的肩胛骨骨折均可通过微创切口入路完成，尤其适用于肩胛骨的体部骨折及肩胛冈骨折以及肩胛颈骨折盂缘骨折盂窝骨折。这是肩胛骨骨折手术治疗的一种安全有效方法。Abstract: Objective: To evaluate the therapeutic and indications of scapular fractures treated by incision minimally invasive.Method: The data of 17 cases of scapular fractures from February 2004 to 2012 in our hospital were reviewed,including 15 male cases and 2 female cases.Their age ranged from 19 to 75 years with a average of 39 years.Of the 17 cases,9 cases had globoid fracture,3 cases had scapula protruding parts fracture,5 cases had scapular body fracture,8 cases had traffic accident wound,5 cases had falls injury,2 cases had direct violence injury,2 cases had stabs,14 cases had closed fracture,3 cases had open fracture.According to Hard egger genotyping methods,6 cases had body fractures,5 cases had scapular fractures,2 cases had scapular neck fracture,2 cases had labrum glenoidable fracture,2 cases had glenoid fossa fracture.Meanwhile,10 cases had mixed fracture,5 cases had complicated by systemic injuries.These scapular fractures cases were fixed by reconstruction plate or lag screws and wire through minimally invasive surgical incision.Result: 17 patients were followed up by 6 months to 3 years with a average of 18 months.The effect was evaluated with Rowe standard,and it was excellent in 11 cases,good in 2,fair in 2 and poor in 2,and the excellent and good rate was 83.7%.2 cases complicated postoperative traumatic arthritis shoulder.Conclusion: Scapular fractures fixed by minimally invasive surgical incision were simple operation,adequately exposure and reliable effect.All types of scapular fractures could operated by minimally invasive surgical approach especially in body fractures,scapular fractures,scapular neck fracture,labrum glenoidable fracture and glenoid fossa fracture,but except scapular body splintered fracture or foating shoulder.It's a safe and effective surgical methods of scapular fractures.
-
Key words:
- Scapular fractures /
- fracture typejminimally /
- invasive incision
-
-
[1] HARGEGGER F H, SIMPSON L A, WEBER B G.The operative treament of scapular fracture[J].J Bone and Joint Surg (Br), 1984, 66:725-731.
[2] 杨志, 赵劲民, 韦庆军, 等.AO钢板内固定治疗肩胛骨颈部骨折[J].中国矫形外科杂志, 2002, 10(11):1124-1124.
[3] CONSTANT C R, MURLEY A H.A clinical method of functional assessment of the shoulder[J].Clin Orthop, 1987, 214:160-164.
[4] 韦向东, 苏义生.手术治疗肩胛骨骨折[J].中国矫形外科杂志, 2005, 13:636-637.
[5] SCHANDELMAIER P, BLAUTH M, SCHNEIDER C, et al.Fracture of the glenoid treated by operation[J].J Bone Joint Surg (Br), 2002, 84:173-177.
[6] 张翼, 文皓, 谢佰彤.肩胛骨外侧缘直切口手术治疗肩胛骨颈下和体部骨折[J].中华创伤杂志, 2005, 21(6):424-426.
[7] 王建, 周跃, 张正丰, 等.改良肩后入路手术治疗肩胛骨骨折[J].创伤外科杂志, 2005, 7(3):189-191.
[8] 郑炜.肩胛骨骨折的外侧切口进路的手术治疗[J].浙江临床医学杂志, 2006, 8(6):601-601.
[9] 苏伟, 王亚军, 赵凡, 等.肩胛骨骨折[J].实用骨科杂志, 2007, 13(3):152-155.
[10] ROWE C R.Evaluation of the shoulder[M].In:Rowe CR ed.The shoulder.1st ed.New York:Churchill Livingstone, 1988:631-637.
[11] 王亦德, 刘泾, 姜保国, 等.骨与关节损伤.4版.北京:人民卫生出版社, 2007:135-148, 776-785.
[12] 贾健.肩胛骨骨折的分类及手术治疗[J].中华骨科杂志, 2003, 23(2):100-104.
[13] 叶小雨, 林初勇, 赖宪良, 等.肩胛骨骨折的分类及治疗方法的选择[J].中国骨与关节损伤杂志, 2006, 21(6):420-422.
[14] 闫瑞忠, 任龙韬.肩胛骨骨折的分类与治疗进展[J].中国骨与关节损伤杂志, 2006, 21(9):764-766.
[15] 张桂华, 徐国荣, 许斌, 等.手术治疗肩胛骨骨折[J].浙江临床医学, 2005, 7(6):611-611.
[16] 王兆杰, 安荣泽, 薛黔, 等.肩胛盂骨折后方手术入路的解剖及临床应用[J].中国矫形外科杂志, 2001, 8(7):656-658.
[17] 王满宜.肩关节外科领域的发展与现状[J].中华创伤骨科杂志, 2005, 3(2):85-90.
-
计量
- 文章访问数: 113
- PDF下载数: 77
- 施引文献: 0
下载: