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肩胛骨骨折的延迟手术治疗

Delayed operative management of fractures of the scapula.

作者信息

Herrera D A, Anavian J, Tarkin I S, Armitage B A, Schroder L K, Cole P A

机构信息

University of Minnesota, Regions Hospital, Saint Paul, Minnesota, USA.

出版信息

J Bone Joint Surg Br. 2009 May;91(5):619-26. doi: 10.1302/0301-620X.91B5.22158.

Abstract

Between 1998 and 2007, 22 patients with fractures of the scapula had operative treatment more than three weeks after injury. The indications for operation included displaced intra-articular fractures, medialisation of the glenohumeral joint, angular deformity, or displaced double lesions of the superior shoulder suspensory complex. Radiological and functional outcomes were obtained for 16 of 22 patients. Disabilities of the Arm, Shoulder, Hand (DASH) and Short form-36 scores were collected for 14 patients who were operated on after March 2002. The mean delay from injury to surgery was 30 days (21 to 57). The mean follow-up was for 27 months (12 to 72). At the last review the mean DASH score was 14 (0 to 41). Of the 16 patients with follow-up, 13 returned to their previous employment and recreational activities without restrictions. No wound complications, infection or nonunion occurred. Malunion of the scapula can be prevented by surgical treatment of fractures in patients with delayed presentation. Surgery is safe, effective, and gives acceptable functional results.

摘要

1998年至2007年期间,22例肩胛骨骨折患者在受伤三周后接受了手术治疗。手术指征包括关节内移位骨折、盂肱关节内移、角形畸形或肩上部悬吊复合体的移位双损伤。22例患者中有16例获得了影像学和功能结果。收集了2002年3月后接受手术的14例患者的上肢、肩部和手部功能障碍(DASH)评分及简短健康调查36项量表(Short form-36)评分。受伤至手术的平均延迟时间为30天(21至57天)。平均随访时间为27个月(12至72个月)。在最后一次复查时,平均DASH评分为14分(0至41分)。16例接受随访的患者中,13例恢复了之前的工作和娱乐活动,且没有限制。未发生伤口并发症、感染或骨不连。对于延迟就诊的肩胛骨骨折患者,通过手术治疗可预防畸形愈合。手术安全、有效,且能取得可接受的功能结果。

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