Karthik Karuppaiah, Lau Jason, Sinha Joydeep, Tavakkolizadeh Adel
Department of Orthopaedic Surgery, King's College Hospital, Denmark Hill, London, United Kingdom.
Int J Shoulder Surg. 2014 Jul;8(3):90-3. doi: 10.4103/0973-6042.140117.
We report a case of bilateral scapular spine stress fracture, treated conservatively on one side and operatively on the other side. Besides, we performed a literature review to establish management options. A 61-year-old right-handed gentleman came to our clinic with acute on chronic deterioration of shoulder pain and loss of arm function. Clinical assessment and investigations revealed long-standing bilateral rotator cuff tear and scapular spine stress fractures. The fracture on the right side united with conservative management for 2 months. However, his left side remained symptomatic with pain, abnormal mobility and no radiological evidence of union. The fracture progressed to union after fixation and bone grafting. At the final follow-up at 2 years, the patient was asymptomatic with regards to the fractures with Oxford Shoulder Score (OSS)-30 and Disabilities of the Arm, Shoulder and Hand (DASH)-30.8. Fracture union either by conservative or operative treatment is associated with good functional outcome and is supported by our review.
我们报告一例双侧肩胛冈应力性骨折病例，一侧采用保守治疗，另一侧采用手术治疗。此外，我们进行了文献综述以确定治疗方案。一名61岁右利手男性因肩部疼痛慢性急性加重及手臂功能丧失前来我院就诊。临床评估和检查发现存在长期双侧肩袖撕裂及肩胛冈应力性骨折。右侧骨折经2个月保守治疗后愈合。然而，其左侧仍有疼痛、异常活动等症状，且影像学检查无愈合迹象。左侧骨折经固定及植骨后愈合。在2年的最终随访时，患者骨折处无症状，牛津肩部评分（OSS）为30分，上肢、肩部和手部功能障碍评分（DASH）为30.8分。我们的综述支持保守或手术治疗导致的骨折愈合均与良好的功能预后相关。
