不稳定肩胛骨骨折的手术治疗

目的探讨肩胛骨不稳定骨折的手术治疗。方法随访分析1999年1月至2004年1月收治的经手术治疗的16例不稳定肩胛骨骨折患．根据Hardegger分类方法，肩胛盂窝骨折4例、解剖颈骨折6例、外科颈骨折4例、粉碎性骨折2例。结果16例患有12例获得完整随访资料．随访时间3个月～4年，平均21月，采用Hardegger肩关节功能评定标准，优4例，良6例，可2例。优良率83．3％．平均骨折临床愈合时间8周。结论a)不稳定肩胛骨骨折畸形愈合严重影响肩关节功能，需行手术切开复位内固定治疗。b)对肩胛骨骨折治疗前需要进行全面的X线摄片检查和CT检查，以全面了解骨折情况，判断骨折的稳定性及有无手术指征。c)对有手术指征的不稳定肩胛骨骨折应根据不同骨折的部位和形态，选择相应的手术人路和内固定物进行手术治疗。

Surgical Treatment of Unstable Scapular Fracture

Objective To discuss the surgical treatment of unstable scapular fracture. Methods 16 cases with scapular fracture that admitted to our hospital were treated by surgical operation from January 1999 to January 2004. There were 4 fractures of glenoid fossa,6 fractures of anatomical neck, 4 fractures of surgical neck, 2 cases of smash fracture. Results 12 cases of 16 were followed up for 3 months to 4 years, According to Hardegger evaluation, 4 cases showed excellent results, 6 good, 2 fair, The average clinical healing time last for 8 weeks. Conclusion a)Abnormal healing of unstable scapular fracture will affect the function of shoulder severely. b)Before treatment of scapular fracture,the patients should be examined by X-ray and CT scan to judge the stability and surgical indication. c)The unstable scapular fracture with surgical indication should be treated by different surgical entry and internal fixation according to different type of fracture.