肩后入路内固定治疗不稳定性肩胛骨骨折

目的：探讨不稳定性肩胛骨系列骨折的手术适应证与开放复位内固定的治疗效果。方法：22例肩胛骨骨折，男18例，女4例，年龄25～65岁，平均35．5岁。根据术前X线片与CT扫描对骨折进行分型，确定手术指征，经肩后入路行切开复位，采用重建钢板、微型钢板、拉力螺钉内固定，术后早期功能锻炼。结果：22例均获9～28个月随访，平均17．5个月，疗效优14例，良5例，可2例，差1例，优良率86．4％。所有骨折平均在术后8．5周骨性愈合。结论：对不稳定性肩胛骨骨折行开放复位内固定、早期功能锻炼可恢复较好的肩关节功能。

Operative treatment for unstable scapular fracture with posterior approach

Objective:To investigate the operative indication and the outcomes of unstable fractures of scapular with open reduction and internal fixation.Methods:There were 22 cases of scapular fracture,male 18,female 4.The average age was 35 5 years old(from 25 to 65).Before operation,scapular fractures were classified with X ray and CT scan,and treated with open reduction and internal fixation.The patients were requested to do earlier rehabilitation after operation.Results:All cases were followed for an average of 17 5 months(from 9 to 28 months) with the results of excellent 14 cases,good 5,ordinary 2,poor 1.Excellent and good percentage is 86 4%.All fractures healed in average 8 5 weeks after operation.Conclusion:Open reduction with internal fixation and early rehabilitation can lead to good function of the shoulder for unstable scapular fracture.