Tadros Ayman M A, Lunsjo Karl, Czechowski Janusz, Abu-Zidan Fikri M
Department of Orthopaedics, Al Ain Hospital, Al Ain, United Arab Emirates.
J Trauma. 2007 Oct;63(4):889-93. doi: 10.1097/01.ta.0000235876.32569.db.
We aimed to study the relationship between the number of fractured scapular regions, and the severity and distribution of associated injuries in blunt trauma patients.
One hundred seven consecutive patients with fractured scapulae (100 men) with a mean age of 35 (8-65) years were prospectively studied between January 2003 and December 2005. Mechanism of injury, associated injuries, Injury Severity Score (ISS), and the number of anatomic scapular regions involved in each fracture were studied. Patients were divided into single-region fracture (SRF), two-region fracture, and more than two-region fracture groups. Computer tomography was used for fracture classification in 99 patients and plain radiographs were used for the remaining 8.
Road traffic collisions were the most common cause of scapular fracture. Ninety-five patients (89%) sustained associated injuries. The most frequent was chest injury (68 [64%]). The median ISS was 9 (4-57) for the SRF group (n = 55), 20 (4-59) for the two-region fracture group (n = 30), and 22.5 (4-54) for the more than two-region fracture group (n = 22) (p = 0.02, Kruskal-Wallis test). The median values of the Abbreviated Injury Scale for chest injuries for the three groups were 1 (0-4), 3 (0-5), and 3 (0-5), respectively (p = 0.001, Kruskal-Wallis test). The SRF group had significantly less posterior structure injury (9 of 55) compared with the multiple-region fracture group (46 of 52) (p < 0.001, Fisher's exact test).
Associated injuries are common in patients with scapular fractures. ISS and Abbreviated Injury Scale score for chest injuries are higher and posterior structure injuries are more frequent in patients with fractures involving multiple scapular regions.
我们旨在研究钝性创伤患者肩胛骨骨折区域数量与相关损伤的严重程度及分布之间的关系。
2003年1月至2005年12月期间，对107例连续的肩胛骨骨折患者（100例男性）进行前瞻性研究，平均年龄35岁（8 - 65岁）。研究损伤机制、相关损伤、损伤严重程度评分（ISS）以及每次骨折累及的肩胛骨解剖区域数量。患者分为单区域骨折（SRF）组、双区域骨折组和两个以上区域骨折组。99例患者采用计算机断层扫描进行骨折分类，其余8例采用X线平片。
道路交通事故是肩胛骨骨折最常见的原因。95例患者（89%）伴有其他损伤。最常见的是胸部损伤（68例[64%]）。SRF组（n = 55）的ISS中位数为9（4 - 57），双区域骨折组（n = 30）为20（4 - 59），两个以上区域骨折组（n = 22）为22.5（4 - 54）（p = 0.02，Kruskal - Wallis检验）。三组胸部损伤简明损伤量表的中位数分别为1（0 - 4）、3（0 - 5）和3（0 - 5）（p = 0.001，Kruskal - Wallis检验）。与多区域骨折组（52例中的46例）相比，SRF组的后部结构损伤明显较少（55例中的9例）（p < 0.001，Fisher精确检验）。
肩胛骨骨折患者常伴有其他损伤。累及多个肩胛骨区域的骨折患者，其胸部损伤的ISS和简明损伤量表评分更高，后部结构损伤更常见。
