Rausch Valentin, Königshausen Matthias, Schildhauer Thomas A, Seybold Dominik, Gessmann Jan
Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bochum, Germany.
Arthrosc Tech. 2017 Sep 18;6(5):e1619-e1623. doi: 10.1016/j.eats.2017.06.035. eCollection 2017 Oct.
Scapula neck fractures are rare injuries, leaving several treatment options. Standardized markers for operative treatment are a decreased glenopolar angle ≤22°, lateral border offset (LBO) of the glenoid ≥20 mm, angular deformity ≥45°, or LBO ≥15 mm plus angular deformity ≥35°. If operative treatment is not performed before union, the fracture heals malaligned with possible mechanical complications due to a medialized glenoid and the protruding lateral border. Common operative treatment comprises a corrective osteotomy for the anatomic correction of the malunited fracture, leaving intra-articular pathologies like adhesive capsular stiffness unaddressed. Our presented arthroscopic technique for the treatment of sequelae of scapula neck fractures combines a 270° capsulotomy with arthroscopic resection of a protruding lateral border. With use of this technique, excellent shoulder function can be restored with a minimally invasive procedure. Therefore, arthroscopic treatment could be favorable in selected cases of malunited scapula neck fractures.
肩胛颈骨折是罕见的损伤，有多种治疗选择。手术治疗的标准化指标为关节盂极角减小≤22°、关节盂外侧缘偏移（LBO）≥20 mm、成角畸形≥45°，或LBO≥15 mm且成角畸形≥35°。如果在骨折愈合前未进行手术治疗，骨折会畸形愈合，可能因关节盂内移和外侧缘突出而出现机械并发症。常见的手术治疗包括对畸形愈合的骨折进行解剖复位的截骨术，但未解决诸如关节囊粘连僵硬等关节内病变。我们提出的用于治疗肩胛颈骨折后遗症的关节镜技术，将270°关节囊切开术与关节镜下切除突出的外侧缘相结合。使用该技术，通过微创手术可恢复良好的肩部功能。因此，在某些肩胛颈骨折畸形愈合的病例中，关节镜治疗可能是有利的。
