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1.
肩胛骨骨折很少见,占所有骨折的0.5%?1.0%[1-2].高能外伤是导致此类骨折的常见受伤机制.据报道,肩胛骨骨折患者的死亡率在10%?15%,这是因为此类骨折经常伴有肺部、颈椎或颅脑等其他系统损害[3].由于肩胛骨被多块肌肉包裹,为骨折愈合提供了丰富的血管供应,因此大多数肩胛骨骨折保守治疗可获得满意效果[4-5]....  相似文献   

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In the care of pelvic injuries complications arise because of organizational and technical factors, some of which are described here. The following measures are important: autotransfusion, emptying the bladder and catheterization, checking and protection of the colon, correct management of the operation table, and prophylactic measures to avoid thrombosis. From an operational/technical point of view, it is most important that a larger with good exposure route be chosen that takes the anatomical structures into account. Of 123 cases, 20% were not ideally reduced. Twice massive bleeding occurred from the A. glutea superior, once the sacral dura was opened without any adverse effects, infection occurred 8 times and 10 times peroneal paralysis was observed.  相似文献   

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Authors analyse 1792 fractures in children, treated during 10 years in their Department and distributed in age groups. They take the part of conservative treatment of the majority, about two third, of fractures in childhood. They consider as operative indication certain forms of epiphyseal injuries, the dislocated intraarticular fractures, the unstable fractures, certain cases of polytrauma and the open fractures.  相似文献   

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Results of healing in 477 cases of open leg fractures treated in the Central Institut of Traumatology in Budapest are analysed in the article. 47,2% of cases were treated by closed methods. The authors are convinced that careful conservative management leads to good results, if the type of the fracture is suitable. Conditions of operative treatment are outlined. In favourable circumstances a stable internal fixation should be performed, otherwise inramedullary wiring and plaster may hold the fragments until healing occurs. Soft tissues should be handled carefully and placing sutures under tension must be avoided, by all means.  相似文献   

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With the exception of displaced articular glenoid fractures, management of scapular fractures has largely consisted of benign neglect, with an emphasis on motion as allowed by the patient's pain. Better understanding of this injury has resulted in greater acceptance of surgical management of highly displaced variants. However, little agreement exists on indications for surgery, and there is no clear comparative evidence on outcomes for surgically versus nonsurgically managed fractures. Scapular fractures are the result of high-energy mechanisms of injury, and they often occur in conjunction with other traumatic injuries. In addition to performing meticulous physical and neurologic examination, the surgeon should obtain plain radiographs, including AP shoulder, axillary, and scapular Y views. Three-dimensional CT is used to determine accurate measurements in surgical candidates. Surgical approach, technique, and timing are individualized based on fracture type and other patient-related factors.  相似文献   

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张功林  章鸣 《中国骨伤》2008,21(4):313-315
肩胛骨骨折相对少见,多因高能量创伤致肩背部遭受直接暴力所致。常伴有合并伤,高达80%~95%,应注意检查臂丛神经、血管以及同侧肢体损伤。骨折治疗的目的是恢复肩关节无痛性有效的肩关节活动功能。移位性关节盂骨折﹑肩部悬吊复合体联合损伤﹑浮肩损伤以及移位性肩胛颈骨折均应行手术治疗,内固定必须牢固可靠,能耐受早期肩关节活动。康复训练是手术成功的重要因素,术后患者应坚持肩关节活动至骨折牢固愈合。  相似文献   

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目的探讨肩胛骨骨折的损伤特点与治疗策略。方法回顾性分析自2007—09--2012-09收治的138例肩胛骨骨折,包括24例采用非手术治疗,114例采用手术治疗。结果138例获平均16.2个月(12—24个月)的随访。术后X线片显示骨折全部愈合,愈合时间平均11.8周(10-14周)。末次随访时肩关节Constant-Mudey评分平均85.6分(54~100分);术后疗效按Hardegger疗效评价标准判定:优87例,良32例,可15例,差4例,优良率86.2%。结论肩胛骨骨折患者应全面评估损伤情况,完善影像学检查,明确骨折类型和手术指征,选择最佳的治疗方案,争取肩关节功能最大程度的恢复。  相似文献   

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<正>2005年1月~2012年12月,我科对20例肩胛骨骨折患者根据不同类型采用不同手术入路进行早期内固定治疗,取得良好效果,报道如下。1材料与方法1.1病例资料本组20例,男12例,女8例,年龄20~67岁。均为单侧肩胛骨骨折。骨折按解剖区域分型:肩胛盂骨折3例,肩胛颈骨折4例,肩胛体骨折6例,肩胛冈骨折4例,肩峰骨折2例,喙突骨折1例。合并伤:多发性肋骨骨  相似文献   

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目的探讨肩胛骨骨折手术治疗的效果。方法18例肩胛骨骨折患者均手术治疗,术后适当功能锻炼。结果患者均获随访,时间10~29个月。采用Neer标准评定肩关节功能:优良8例,满意7例,不满意3例。结论肩胛骨骨折手术治疗效果尚不确实,应严格选择手术病例,争取早期手术,并早期功能锻炼,可获得满意疗效。  相似文献   

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肩胛骨骨折的手术治疗   总被引:9,自引:4,他引:5  
目的探讨切开复位内固定治疗肩胛骨骨折的适应证及疗效.方法对9例患者经肩后入路行切开复位,采用重建钢板、拉力螺钉或克氏针内固定, 术后早期功能锻炼.结果 9例随访12~40个月,疗效:优6例,良2例,可1例.结论在严格掌握手术指征的基础上对肩胛骨骨折行内固定治疗,利于早期功能锻炼,减少并发症,肩关节功能恢复较好.  相似文献   

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肩胛骨骨折的手术治疗   总被引:3,自引:1,他引:3  
目的 :探讨手术治疗各型肩胛骨骨折的可行性及适应证 ,评价手术治疗的临床疗效。方法 :对手术治疗并获随访的 2 5例肩胛骨骨折进行回顾性分析。术前常规行肩胛骨的正位、侧位及前 30°斜位的X线摄片 ,用Jesser法将骨折进行分型 ,手术采用Judet入路进行骨折内固定。结果 :术后随访 8个月至 3年 5个月 ,平均 2 0个月 ,按Dolfi等评分系统进行功能评定 ,优 (13~ 16分 ) 10例 ,良 (9~ 12分 )11例 ,可 (5~ 8分 ) 3例 ,差 (小于 4分 ) 1例 ,优良率为 84 %。结论 :手术治疗肩胛骨骨折已成为安全、可靠的治疗手段 ,累及关节面并有移位的肩盂骨折、有移位的肩胛骨颈部骨折以及肩胛冈粉碎性骨折是手术治疗的绝对适应征。对预期功能要求比较高的病人 ,可适当放宽手术指证。熟练的手术技巧和可靠的内固定以及早期积极的功能锻炼是提高疗效的关键  相似文献   

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目的探讨肩胛骨骨折手术治疗的效果。方法对30例肩胛骨骨折患者根据不同类型分别采用不同手术入路进行内固定治疗。术后进行科学功能锻炼。结果患者均获随访,时间6~36个月。采用ASES评分标准评定肩关节功能:优20例,良7例,中等2例,差1例。结论肩胛骨骨折早期手术,术后科学功能锻炼,可获得满意疗效。  相似文献   

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The significance of scapular fractures   总被引:2,自引:0,他引:2  
Scapular fractures in the multiply injured patient have received little attention. Fifty-six patients with 58 scapular fractures secondary to blunt trauma were reviewed. The patients averaged 3.9 major injuries excluding their scapular fractures. The injury pattern associated with blunt scapular fracture is unique. Patients with scapular fracture have a high incidence of injury to the ipsilateral lung and chest wall and to the ipsilateral shoulder girdle and its contained structures: rib fractures, 53.6%; pulmonary contusions, 53.6%; clavicular fracture, 26.8%; brachial plexus injury, 12.5%; subclavian, brachial, or axillary artery injury, 10.7%. Eight patients died (14.3%). Although no patient died from the scapular fracture, half of the deaths in this series were the result of pulmonary sepsis arising in an associated ipsilateral pulmonary contusion. Scapular fractures provide the trauma surgeon with a reliable clinical clue that the patient is at inordinate risk to have associated injuries of major consequence to the ipsilateral lung and chest wall, the ipsilateral shoulder girdle, and the ipsilateral subclavian, axillary, or brachial artery.  相似文献   

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Acute surgical management of Jones' fractures   总被引:2,自引:0,他引:2  
The purpose of this study was to evaluate the effectiveness of surgical management for acute Jones' fractures and Torg types I and II proximal diaphyseal stress fractures presenting acutely in both athletes and nonathletes. Twenty-two patients underwent intramedullary screw fixation between 1994 and 1999. Immediate intramedullary screw fixation of acute Jones' fractures and type I stress fractures resulted in a 100% union rate with an average time to union of 6.2 weeks. Fixation of type II stress fractures had a union rate of 100% with a mean time to union of 8.3 weeks. The overall complication rate was 9%. Surgical intervention allowed an earlier return to weight-bearing with a more rapid and predictable union rate. The authors recommend intramedullary fixation as a treatment of choice for the management of fifth metatarsal fractures distal to the tuberosity in nonathletes as well as athletes.  相似文献   

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