Kohler A, Käch K, Platz A, Friedl H P, Trentz O
Departement Chirurgie, Universitätsspital Zürich.
Z Unfallchir Versicherungsmed. 1992;85(3):140-4.
The combination of an ipsilateral clavicule and scapula fracture causes a double instability of the shoulder. In opposite to an isolated clavicule or scapula fracture this injury should be treated operatively. Diagnosis of the scapula fracture in polytrauma can be difficult. If there is a clinical or radiologic suspicion, the indication for a CT scan is given. Osteosynthesis with plates from separated approaches, first the scapula from dorsal then the calvicule from ventral has proven good. The nervus suprascapularis must be treated carefully and, if necessary, liberated from the fracture. The optimal treatment of this injury is not always possible in polytraumatised patient.
同侧锁骨和肩胛骨骨折会导致肩部双重不稳定。与单纯的锁骨或肩胛骨骨折不同，这种损伤应采用手术治疗。在多发伤中诊断肩胛骨骨折可能很困难。如果有临床或影像学怀疑，就应进行CT扫描。采用分开入路用钢板进行骨合成，先从背侧固定肩胛骨，然后从腹侧固定锁骨，已证明效果良好。必须小心处理肩胛上神经，必要时将其从骨折处游离出来。对于多发伤患者，并不总是能够对这种损伤进行最佳治疗。
