Zhou Yu-Cheng, Yu Lin-Xin, Duan Hong, Min Jie, Yuan Xiao-Feng, Yu Peng, Nie Bang-Xu, Hu Jun
Department of Orthopaedics, the First People's Hospital of Kunming, Kunming 650011, Yunnan, China.
Department of Orthopaedics, the First People's Hospital of Kunming, Kunming 650011, Yunnan, China;
Zhongguo Gu Shang. 2017 Oct 25;30(10):952-956. doi: 10.3969/j.issn.1003-0034.2017.10.014.
To investigate the clinical results of scapula fractures with lateral incision combined with bridge internal fixation system.
From October 2012 to December 2016, 20 cases of scapular fractures were treated through the lateral incision combined with bridge fixation system, including 15 males and 5 females, with an average age of 31.6 years old(ranged, 21 to 52 years old). Fourteen cases were scapular body fracture, 10 were scapular neck fracture, 6 were scapular fracture, 1 was acromion fracture, 1 was coracoid fracture, 4 were the glenoid rim fracture, 3 were the glenoid fossa fracture. The operation time ranged from 4 to 15 d after injury with an average of 10 d.
All 20 cases were followed up for 3 to 24 months with an average of 15 months. Wound infection occurred in 2 cases after operation, and was healed after wound debridement and change dressing; no osteomyelitis, iatrogenic nerve injury, breakage of internal fixation, fracture displacement, joint stiffness occurred. Callus growth was observed at the fracture site 3 months after operation, the fracture healing time was 4 to 7 months, fracture healing was good without delayed union or malunion. According to Hardegger shoulder score, the results were excellent in 12 cases, good in 6 cases, moderate in 2 cases.
Lateral incision approach combined with bridge internal fixation system for scapula fractures has the advantages of easy operation, revealed clearly, and the incision can be arbitrary to extend on both sides, to provide favorable conditions for the reduction and fixation of fracture. Bridge combined internal fixation system has the advantages of flexible operation, reliable fixation strength, is a good choice for treatment of scapula fracture.
探讨采用外侧切口联合桥接内固定系统治疗肩胛骨骨折的临床效果。
2012年10月至2016年12月,采用外侧切口联合桥接固定系统治疗肩胛骨骨折20例,其中男15例,女5例,平均年龄31.6岁(21~52岁)。肩胛体骨折14例,肩胛颈骨折10例,肩胛盂骨折6例,肩峰骨折1例,喙突骨折1例,肩胛盂缘骨折4例,肩胛盂窝骨折3例。受伤至手术时间4~15 d,平均10 d。
20例均获随访,时间3~24个月,平均15个月。术后2例发生伤口感染,经伤口清创换药后愈合;未发生骨髓炎、医源性神经损伤、内固定断裂、骨折移位、关节僵硬。术后3个月骨折部位见骨痂生长,骨折愈合时间4~7个月,骨折愈合良好,无延迟愈合或畸形愈合。根据Hardegger肩关节评分标准,优12例,良6例,可2例。
外侧切口联合桥接内固定系统治疗肩胛骨骨折具有操作简便、显露清楚、切口可向两侧任意延长等优点,为骨折的复位和固定提供了有利条件。桥接联合内固定系统操作灵活、固定强度可靠,是治疗肩胛骨骨折的较好选择。