Qin Hui, Hu Chuan-Zhen, Zhang Xian-Long, Shen Long-Xiang, Xue Zi-Chao, An Zhi-Quan
Orthopedics. 2013 Oct 1;36(10):e1244-50. doi: 10.3928/01477447-20130920-14.
Ideberg type III glenoid fractures with associated superior shoulder suspensory complex (SSSC) injuries are rare, and related treatments have not been reported in the literature. The purpose of this study was to evaluate the clinical outcomes of such injuries treated with open reduction and internal fixation (ORIF). Between July 2007 and April 2012, ten patients with Ideberg type III glenoid fractures were surgically treated using ORIF with 2 cannulated screws or a screw combined with a metacarpal plate through an anterior approach. Patients with associated SSSC injuries underwent ORIF with K-wires or plates. Information was available for 9 patients with a mean follow-up of 24.1±18.2 months. Mean bone-healing time was 8.4±2.2 weeks. At last follow-up, mean forward flexion of the operative shoulder was 157.8°±7.5°, mean external rotation was 62.9°±7.9°, and mean internal rotation was thoracic level T6±0.8. Mean Constant score was 84.1±3.7 points, which was a mean of 92.7%±3.4% of that seen in the contralateral shoulder. Mean UCLA score and Disabilities of the Arm, Shoulder and Hand score were 33.6±1.7 and 16.6±7.7, respectively. The results show that Ideberg type III glenoid fractures with associated SSSC injuries can be successfully treated using ORIF through an anterior approach. Glenoid fractures and SCCC injuries should be treated simultaneously.
伴有肩上部悬吊复合体（SSSC）损伤的IdebergⅢ型肩胛盂骨折较为罕见，相关治疗方法在文献中尚无报道。本研究旨在评估切开复位内固定（ORIF）治疗此类损伤的临床疗效。2007年7月至2012年4月期间，10例IdebergⅢ型肩胛盂骨折患者采用前路切开复位内固定术，使用2枚空心螺钉或1枚螺钉联合掌骨钢板进行手术治疗。伴有SSSC损伤的患者采用克氏针或钢板进行切开复位内固定。9例患者资料完整，平均随访时间为24.1±18.2个月。平均骨愈合时间为8.4±2.2周。末次随访时，患侧肩部平均前屈角度为157.8°±7.5°，平均外旋角度为62.9°±7.9°，平均内旋角度为胸6水平±0.8。Constant评分平均为84.1±3.7分，为对侧肩部评分的92.7%±3.4%。UCLA评分和上肢、肩部和手部功能障碍评分分别为33.6±1.7和16.6±7.7。结果表明，伴有SSSC损伤的IdebergⅢ型肩胛盂骨折采用前路切开复位内固定术可获得成功治疗。肩胛盂骨折和SCCC损伤应同时进行治疗。
