手术治疗肩胛骨骨折7例

目的探讨肩胛骨骨折(scapular fracture，SF)的临床特点和手术治疗方法。方法对我院1998年1月～2003年6月收治的经手术治疗并全部得到随访的7例肩胛骨骨折的类型，手术方法及随访结果进行回顾性分析。结果经X线摄片检查和cT三维重建检查，7例中肩胛骨体部骨折4处，肩胛颈骨折3处，盂缘骨折2处，肩胛冈骨折2处，肩峰骨折2处。其中混合骨折5例，伴有合并伤者6例。在伤后一至三周经后方入路或后上方入路分别给予重建钢板，螺钉或张力带钢丝固定。随访16～25个月，平均19个月。骨折全部愈合，无明显后遗症，临床疗效满意。结论肩胛骨骨折多由高能暴力所致，常有严重的合并伤。CT三维重建对于明确骨折类型和选择治疗方法有明显的帮助。对移位严重的肩胛骨骨折，手术治疗是一种安全有效的方法。

The Operative Treatment of Scapular Fractures

Objective To explore the clinical characteristics and operative treatment methods ofscapular fracture. Methods The characteristics of fracture, operative methods and the clinicaloutcomes of seven cases with scapular fracture received operation that admitted to our hospital fromJanuary 1998 to June 2003 were retrospectively analyzed. Results X-ray and three-dimensional CTreconstructions were used to confirm injuries. In seven cases of the scapular fracture, there are 4fractures of the scapular body, 3 fractures of the scapular neck, 2 fractures of glenoid rim,2 fracture ofthe scapular spine, 2 fracture of the acromion. Of the 7 patients, 5 cases had complex fracture of thescapular and 6 cases had associated injuries. On the basis of the fracture patterns, posterior,posterosuperior proach were performed with plates or lag patirents for reconstruction. All patients werefollowed up with an average of 19 months. The effect of treatment is satisfied. Conclusion Scapularfracture is caused by hing-energy violencc with a high incidence of serious associated injury.Computerized tomography scanning with three-dimensional imaging is helpful to determine thefracture pattern, degree of displacement and method of treatment. Open reduction and internal fixationis a useful and safe technique for the treatment of specific displaced fracture of the scapula.