手术治疗肩胛骨骨折23例临床分析

目的探讨肩胛骨骨折的手术适应证与手术复位内固定的临床效果。方法回顾性分析2000年11月-2006年10月手术治疗23例肩胛骨骨折患者临床资料，骨折位于肩胛冈6处，肩峰3处，肩胛盂6处，体部12处，颈部11处。采用肩胛骨腋窝缘入路15例，后入路8例。术后早期功能锻炼。结果本组均获随访，平均29.6（12-48）个月，X线片显示所有患者均于11（10-12）周达到临床愈合。肩关节功能评定：优15例，良5例，可2例，差1例，优良率为86.96%。发生创伤性关节炎1例，无切口感染和骨不连。结论手术治疗肩胛骨骨折能及时恢复肩关节的动力平衡和稳定性，是一种安全可靠的治疗方法；合理的运用手术入路和内固定方式，早期行功能锻炼，可取得满意的临床疗效。

Surgical Treatment of Scapular Fractures(A Report of 23 Cases)

Objective To discuss the indication and effect of surgical treatment of open reduction and internal fixation for scapular fractures.Methods From November 2000 to October 2006,23 patients of scapular fractures underwent open reduction and internal fixation were reviewed.There were 6 fractures in scapular spine,3 fractures in acromion,6 fractures in scapular glenoid,12 fractures in scapular body and 11 fractures in scapular neck.15 cases were treated via the axillary fossa border approach and 8 cases via posterior approach.Results 23 cases were followed up for 12～48 months.All cases were cured within 10 to 12 weeks after operation.The shoulder joint function showed excellent in 15 cases,good in 5 cases,fair in 2 cases and failed in 1 case.The fineness rate was 86.96%.One case occurred traumatic arthritis.No infection and nonuion occurred.Conclusion Open reduction and internal fixation can restore the dynamic equilibrium and stability of shoulder joint,and is a safe and reliable therapy for scapular fracture;The satisfactory results can be achieved by appropriate selection of surgical approach and internal fixation,and actively early functional exercise.