锁定重建接骨板治疗复杂性肩胛骨体部骨折

目的：探讨经改良后侧入路应用重建锁定接骨板固定肩胛骨体部骨折的方法和疗效。方法：2005年8月至2009年11月应用锁定重建接骨板治疗复杂性肩胛骨骨折27例,男19例,女8例;年龄16～64岁,平均36岁;伤后就诊时间0.5h～11d,平均3d。其中合并同侧锁骨骨折9例,肩锁关节脱位2例,多发肋骨骨折16例,肱骨干骨折1例,胸腔积液、肺不张、肺挫伤等5例。术后随访肩关节功能恢复程度。结果：24例患者获得随访,时间2～35个月,平均19个月。按Hardegger肩关节功能评定标准,优15例,良7例,可2例。结论：经改良后侧入路利用锁定重建接骨板治疗复杂性肩胛骨体部骨折具有创伤小、暴露清楚、固定坚强可靠、可早期行关节功能活动等优点。

Treatment of complex scapular body fractures by locking reconstructive plates

Objective: To investigate the method and effect of treatment of complex scapular body fractures by locking reconstructive plate through modified posterior approach. Methods: From August 2005 to November 2009,27 patients with complex scapula body fractures were treated by locking reconstruction bone plate fixation,including 19 males and 8 females with an average age of 36 years old ranging from16 to 64 years. The time after injury was 0.5 hours to 11 days (averaged 3 days). Of all the patients,9 cases were associated with ipsilateral clavicle fracture,2 cases were associated with acromioclavicular joint dislocation,16 cases were associated with multiple rib fractures,1 case were associated with humeral shaft fractures,5 cases were associated with pleural effusion,atelectasis,lung contusion etc. After operating,shoulder functional recovery were followed up. Results: Twenty-four patients were followed up from 2 to 35 months with an average of 19 months. According to Hardegger shoulder function,the results were excellent in 15 cases,good in 7 cases,general in 2 cases. Conclusion: This method had the advantage of less trauma and clear exposure,firm and reliable fixation,and early activities.