肩胛骨骨折的手术治疗

目的探讨肩胛骨骨折的临床特征及手术疗效。方法对于2002年3月至2007年3月本院手术治疗不稳定肩胛骨骨折共20例的临床资料进行回顾性分析。按照Miller分型方法Ⅰ—A2例，Ⅰ—B1例，Ⅱ—C1例；Ⅱ-A2例，Ⅱ一B2例，Ⅱ—C5例。Ⅲ2例，Ⅳ5例。根据骨折类型选择手术入路（后入路17例，前入路3例），内固定物分别或结合应用“K”钢板，重建钢板，拉力螺钉固定骨折。结果全部病例均获随访，随访6月～28月，平均14月。根据Hercovici疗效标准，术后肩关节的功能评分为4～16分，平均14．5分，优良率为92．8％。结论手术治疗不稳定肩胛骨骨折能使患者早期功能锻炼，改善肩关节功能。

Surgical treatment of scapular fracture

Objective To explore the clinical feature and operative efficacy for displaced fracture of the scapula. Methods From March 2002 to March 2007,20 cases with displaced fracture of the scapula received open reduction and intrnal fixation were analyzed retrospectively. All fractures were classified according to Miller System and were exposed through posterior approach （17 cases）, anterior approach （3 cases）. ‘K＇ plates, reconstruction plates and lag screws were used to fixe the fracture after reduction. Result All patients were followed up for 6 months to 28 months, with an average of 14 months. According to Herscovice criterion, the average score was 14.5（rang 4-16）.with an excellence and good rate of 90% The radiographs showed that all the fractures were healed. Conclusion Open reduction and internal fixation in the treatment of unstable fractures of scapula can make early functional exercise and achieve a satisfactory clinical outcome.