Yuan Zheng, Zhang Fan, Liang Guanzhao, Zeng Xianshang, Liu Dan, Yang Chen, Yu Weiguang, Zhang Qiang, Zhang Xinchao
1 Department of Orthopaedics, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
2 Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China.
J Int Med Res. 2018 Jul;46(7):2731-2742. doi: 10.1177/0300060518770568. Epub 2018 May 29.
Objective To compare surgical complications and functional outcomes of the ring plate versus the non-ring plate approach to the surgical repair of scapular body fractures (SBFs; AO/OTA classification: 14-A2.2). Methods This retrospective study reviewed data from adults with SBFs who underwent a modified Judet approach combined with non-ring or ring plates between November 2006 and June 2013. The primary outcomes were the Constant and Murley score and the Disabilities of the Arm, Shoulder and Hand (DASH) score. The secondary outcomes were radiographic findings. Results A total of 318 patients had a non-ring or ring plate internal fixation, of which 147 patients (ring-treated, n = 72; non-ring-treated, n = 75) were evaluated with a mean follow-up period of 60 months. At the 3-month follow-up, the complication rate was 2.8% and 13.3% for the ring-treated and non-ring-treated groups, respectively. The difference persisted over time, with significantly different rates of 8.3% and 20.0% at the final follow-up for the ring and non-ring groups, respectively. The ring-treated group had significantly higher postoperative Constant and Murley scores and lower DASH scores compared with the non-ring-treated group. Conclusion Application of a modified Judet approach combined with ring plate internal fixation for the treatment of SBFs may be the preferred treatment option.
目的 比较环形钢板与非环形钢板治疗肩胛体骨折（SBF；AO/OTA分类：14-A2.2）的手术并发症及功能结局。方法 本回顾性研究回顾了2006年11月至2013年6月期间接受改良Judet入路联合非环形或环形钢板治疗的成年SBF患者的数据。主要结局指标为Constant和Murley评分以及上肢、肩部和手部功能障碍（DASH）评分。次要结局指标为影像学表现。结果 共有318例患者接受了非环形或环形钢板内固定，其中147例患者（环形钢板治疗组，n = 72；非环形钢板治疗组，n = 75）接受评估，平均随访时间为60个月。在3个月随访时，环形钢板治疗组和非环形钢板治疗组的并发症发生率分别为2.8%和13.3%。这种差异随时间持续存在，在最终随访时，环形钢板组和非环形钢板组的并发症发生率分别为8.3%和20.0%，差异有统计学意义。与非环形钢板治疗组相比，环形钢板治疗组术后Constant和Murley评分显著更高，DASH评分更低。结论 应用改良Judet入路联合环形钢板内固定治疗SBF可能是首选的治疗方案。
