微型钉棒系统治疗肩胛骨骨折的临床研究

目的 总结应用微型钉棒系统肩胛骨骨折的治疗疗效.方法 肩胛骨复杂骨折患者28例,骨折按 Miller分型ⅠA型8例,ⅠB型9例,ⅡA型5例,ⅡB型4例,Ⅲ型2例.采用后侧改良的Judet入路将肌群向外侧翻开暴露骨折,根据骨折情况将骨折断端附近打入对称性双数固定钉后复位压棒固定.结果 术后19例获得随访,随访时间4～12个月,平均7.8个月.术后4～6周X线片均可见骨折线模糊,10例患者术后12周达到临床愈合,9例于术后20周左右达到临床愈合.伤口均一期愈合,无一例发生感染及局部不良反应和疼痛,平卧休息患肢无不适.患肢肩胛骨活动及肩关节活动度根据Rowe疗效评价标准,优16例,良2例,可1例,优良率为94.7%.结论 应用微型钉棒系统治疗肩胛骨骨折疗效可靠,值得总结和推广.

Application of micro-screw system in the treatment of scapular fracture

Objective To examine the clinical efficacy of application of micro - screw system in the treatment of scapular fracture. Methods From July 2007 to September 2010, micro - screw system was used in the treatment of 28 scapular fracture patients in whom, 19 patients were followed up. Eight patients fell inⅠ A,9 in ⅠB,5 in Ⅱ A,4 in ⅡB and 2 in Ⅲ according to the Miller＇s classification. The muscles were laterally opened to expose the fracture via the Judet posterior approach. Fastening nails were fixed around the ends of facture symmetrically and then replacement was performed. Results The follow - up lasted 4 to 12 months with an average of 7.8 months. X - ray examination revealed a blurred fracture line 4 to 6 weeks after the operation. Clinical cure was obtained in 10 patients 12 weeks after the operation and in 9 patients at 20 weeks. Primary wound healing was achieved in all the patients. No patients developed infection, local complications and pain, and felt discomfort in the diseased limb in the supine position. The function of the shoulder joint were excellent in 16 cases, good in 2 cases and moderate in 1 case according to the Rowe standard. The good rate reached 94.7%. Conclusion Application of micro - screw system is effective in the treatment of scapular fracture and worth popularizing.