切开复位内固定治疗Ideberg Ⅲ型肩胛盂骨折

目的探讨IdebergⅢ型肩胛盂骨折的手术方式及疗效。方法回顾性分析手术治疗IdebergⅢ型肩胛骨骨折患者10例,1例合并肩峰及锁骨外端骨折,1例合并肩峰及肱骨小结节骨折,6例存在肩锁关节的Ⅱ度损伤,2例Ⅲ度损伤。手术入路均为前入路,利用掌骨钢板和/或空心螺钉行切开复位内固定。结果 8例患者获得平均20.1个月随访。对双肩功能均予以Constant评分,根据患肩占正常侧功能的百分比计算,患肩平均分数为(91.9±5)%。加利福尼亚大学洛杉矶分校(university of California at Los Angeles,UCLA)评分(32.5±3.2)分。肩关节前屈度数达(150±21.4)°,外旋度数达(53.8±11.9)°。内旋伸拇指平均可达到T9±3水平。结论经前入路切开复位内固定是治疗IdebergⅢ型肩胛盂骨折的有效方式,结合对合并悬肩复合体损伤的修复,可以取得良好效果,恢复肩关节功能。

Open Reduction and Internal Fixation in Treatment of Ideberg Ⅲ Glenoid Fracture

Objective To explore the surgical treatment of Ideberg type Ⅲ glenoid fractures. Methods The clinical out-comes of 10 cases（one case associated with acromion and lateral clavicle fracture,one with acromion and humeral tuberosity fracture,six with type ⅡA、acromioclavicular joint injury and two with type Ⅲ）of Ideberg type Ⅲ glenoid fractures treated surgically were retrospectively analyzed. The glenoid fractures were open reduced and fixed with metacarpal plates or cannulat-ed screws through an anterior approach . Results 8 patients with Ideberg Ⅲ fractures were followed up with an average of 20. 1 months. The mean Constant score was（91. 9 ± 5）% in compare with that of the contralateral shoulders. The mean UCLA score was（91. 9 ± 5）% points. At the latest visiting,the mean anterior flexion of affected shoulder was（150 ± 21. 4）°,the mean external rotation was（150 ± 21. 4）°and the mean internal rotation were reached to T9 ± 3 respectively. Conclusion Ideberg Ⅲ glenoid fractures can be successfully treated by open reduction and internal fixation through an anterior approach. The glenoid fractures and the injured SCCC should be treated simultaneously.