Department of Orthopaedic Surgery, University of Minnesota, St. Paul, MN, USA.
J Am Acad Orthop Surg. 2012 Mar;20(3):130-41. doi: 10.5435/JAAOS-20-03-130.
With the exception of displaced articular glenoid fractures, management of scapular fractures has largely consisted of benign neglect, with an emphasis on motion as allowed by the patient's pain. Better understanding of this injury has resulted in greater acceptance of surgical management of highly displaced variants. However, little agreement exists on indications for surgery, and there is no clear comparative evidence on outcomes for surgically versus nonsurgically managed fractures. Scapular fractures are the result of high-energy mechanisms of injury, and they often occur in conjunction with other traumatic injuries. In addition to performing meticulous physical and neurologic examination, the surgeon should obtain plain radiographs, including AP shoulder, axillary, and scapular Y views. Three-dimensional CT is used to determine accurate measurements in surgical candidates. Surgical approach, technique, and timing are individualized based on fracture type and other patient-related factors.
除了关节盂关节面移位骨折外，肩胛骨骨折的处理主要是良性忽视，重点是根据患者的疼痛程度来进行活动。对这种损伤的更好理解导致了对高度移位变体的手术治疗的更大接受度。然而，手术适应证尚存在争议，手术治疗与非手术治疗骨折的结果也没有明确的对比证据。肩胛骨骨折是高能损伤机制的结果，它们通常与其他创伤性损伤同时发生。除了进行细致的体格检查和神经检查外，外科医生还应拍摄包括前后位肩部、腋窝位和肩胛骨 Y 位的平片。三维 CT 用于确定手术候选人的准确测量值。手术方法、技术和时机是根据骨折类型和其他患者相关因素个体化的。
