不稳定性肩胛骨骨折的内固定治疗

目的:探讨不稳定性肩胛骨骨折的手术治疗方法及疗效。方法:自2008年10月至2011年8月收治不稳定性肩胛骨骨折14例,其中男12例,女2例;年龄21～55岁,平均38.7岁;伤后至就诊时间1h～10d,平均3d。肩胛体骨折3例,肩胛颈及肩胛体骨折4例,肩胛颈及肩峰端骨折4例,关节盂及喙突部骨折2例,肩胛冈及喙突部骨折1例。14例均采用手术治疗,术后采用Hardegger标准进行功能评定。结果:14例均获得随访,时间2～36个月,平均12.4个月。骨折临床愈合时间6～8周,无切口感染、内固定失败。根据Hardegger标准进行功能评定,优9例,良3例,可2例。结论:手术治疗不稳定性肩胛骨骨折可重建肩关节稳定,促进关节功能早期康复,最大限度地恢复肩关节功能。

Internal fixation for unstable scapular fracture

Objective:To investigate surgical methods and effects of unstable scapular fracture. Methods:From October 2008 to August 2011,14 patients with unstable scapular fracture were treated. There were 12 males and 2 females with an average age of 38.7 years(ranging,21 to 55 years).The time from injury to hospitalization was 1 hour to 10 days (mean 3 days). Among patients,3 patients had scapular body fracture,4 patients had scapular neck and body fracture,4 patients had scapular neck and acromion fracture,2 patients had glenoid cavity and coracoid fracture,1 patient with scapular spine and coracoid fracture. All patients were treated by operation,Hardegger classification system was applied to evaluate the function. Results:All patients were followed up for 2 to 36 months(mean 12.4 months). The healing time ranged from 6 to 8 weeks. No infection and internal fixation failure occurred. The effect result of Hardegger scoring system was excellent in 9 cases,good in 3 cases,fair in 2 cases. Conclusion:Surgical treatment for unstable scapular fracture can reconstruct stability of shoulder joint,promote early rehabilitation of joint function,and maximally restore shoulder function.