Bartoníček Jan, Tuček Michal, Klika Daniel
Department of Orthopaedics, First Faculty of Medicine, Charles University and Central Military Hospital Prague, U Vojenské nemocnice 1200, 169 02, Prague 6, Czech Republic.
Department of Radiology, Central Military Hospital, U Vojenské nemocnice 1200, 169 02, Prague 6, Czech Republic.
Int Orthop. 2017 Sep;41(9):1741-1748. doi: 10.1007/s00264-017-3511-5. Epub 2017 May 25.
A typical feature of inferior glenoid fractures is a distal fragment separated from the glenoid fossa. In most cases, the inferior glenoid fractures are associated with a fracture of the scapular body. However, there are no detailed studies of inferior glenoid fractures, and only brief mentions can be found in the literature in this respect.
The basic group comprised 42 patients, with the mean age of 48 years, who sustained 42 fractures of the inferior glenoid. In this group, the scapular fracture anatomy was evaluated, based on 3D CT reconstructions. A total of 29 patients operated on were followed up for 12 to 128 months after injury (average, 52 months), three patients were lost to follow up. The results of the operative treatment, including complications, were assessed radiologically and functionally.
Fracture anatomy was described from various aspects, i.e., the size of the articular surface carried by the separated glenoid fragment, the existence of multiple articular fragments, the size of the separated glenoid fragment and the extent of injury to the scapular body. All 29 operatively treated fractures radiologically healed within three months. Full and pain-free range of motion was restored in 18 patients; in eight patients it was limited by 20 degrees and in three patients by more than 40 degrees. The mean Constant score was 82.
Fractures of the inferior glenoid fossa requires CT examination, including 3D CT reconstruction with subtraction of the surrounding bones. Displaced fractures are indicated for operative treatment.
肩胛盂下骨折的一个典型特征是远端骨折块与肩胛盂分离。在大多数情况下，肩胛盂下骨折与肩胛骨体部骨折相关。然而，目前尚无关于肩胛盂下骨折的详细研究，在这方面仅能在文献中找到简短提及。
基础组包括42例患者，平均年龄48岁，共发生42例肩胛盂下骨折。在该组中，基于三维CT重建对肩胛骨骨折的解剖结构进行评估。总共29例接受手术治疗的患者在受伤后随访12至128个月（平均52个月），3例失访。通过影像学和功能评估手术治疗的结果，包括并发症。
从多个方面描述了骨折的解剖结构，即分离的肩胛盂骨折块所承载的关节面大小、多个关节骨折块的存在情况、分离的肩胛盂骨折块大小以及肩胛骨体部的损伤程度。所有29例接受手术治疗的骨折在三个月内均获得影像学愈合。18例患者恢复了完全且无痛的活动范围；8例患者活动范围受限20度，3例患者受限超过40度。Constant评分的平均值为82分。
肩胛盂下窝骨折需要进行CT检查，包括三维CT重建并减去周围骨骼。移位骨折适合手术治疗。
