Wu Jin, Fu Xi-jin, Sha Mo, Liu Hui, Chen Zhi-da, Kang Liang-qi
Department of Orthopaedics, The Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of People's Liberation Army, Zhangzhou, 363000, China.
Department of Orthopaedics, The Third Hospital of Zhangzhou, Zhangzhou, 363000, China.
Int Orthop. 2016 Feb;40(2):377-84. doi: 10.1007/s00264-015-2902-8. Epub 2015 Jul 10.
To introduce a surgical method of treating Eyres type IV and V coracoid fracture using the acromion osteotomy approach and to further analyse the clinical effectiveness of this surgical procedure.
Nine patients were included in this study with a mean follow-up time of 23.3 months (range, 14.0-34.0 months). Patients were evaluated with use of the Constant score, the Simple Shoulder Test (SST) score and a visual analogue scale (VAS) pain score. Moreover, the shoulder range of motion was also observed.
The mean operation time was 91.6 min with a blood loss volume ranging from 310 to 530 ml. The fractures of eight patients had recovered between 10 and 12 weeks post operation with no signs of infection, screw loosening, plate breaking or other internal fixation failures, while one case had non-union at 34 months' follow-up. The mean Constant score increased from 75.6 points preoperatively to 91.0 points at follow-up. The mean VAS score decreased from 5.3 preoperatively to 1.0 at follow-up, while the average SST score increased from 7.1 points preoperatively to 10.0 points at follow-up. The mean abduction, forward flexion, external rotation, internal rotation and backward extension angles were 162°, 159° 50°, 55° and 47°. Five cases were classified as excellent, three cases were marked as good and one case was classified as fair.
Treating coracoid fracture through the approach of acromion osteotomy could be an effective treatment option with minimise damages.
介绍一种采用肩峰截骨入路治疗埃尔斯IV型和V型喙突骨折的手术方法,并进一步分析该手术方法的临床疗效。
本研究纳入9例患者,平均随访时间为23.3个月(范围14.0 - 34.0个月)。采用Constant评分、简单肩关节试验(SST)评分和视觉模拟量表(VAS)疼痛评分对患者进行评估。此外,还观察了肩关节活动范围。
平均手术时间为91.6分钟,失血量在310至530毫升之间。8例患者骨折在术后10至12周愈合,无感染、螺钉松动、钢板断裂或其他内固定失败迹象,而1例在随访34个月时出现骨不连。Constant评分平均从术前的75.6分提高到随访时的91.0分。VAS评分平均从术前的5.3分降至随访时的1.0分,而SST评分平均从术前的7.1分提高到随访时的10.0分。平均外展、前屈、外旋、内旋和后伸角度分别为162°、159°、50°、55°和47°。5例评定为优,3例为良,1例为可。
通过肩峰截骨入路治疗喙突骨折是一种有效的治疗选择,可将损伤降至最低。