[切开复位内固定治疗肩锁关节脱位合并喙突骨折]

[Open reduction and internal fixation for multiple injuries of superior shoulder suspensory complex with coracoid process fracture].

作者信息

Yao Xiaoke, Wu Lingna, Li Jianhua, Huang Wengang, Duan Xin, Gu Zuchao, Wang Yue

机构信息

Department of Orthopedics, Chengdu First People's Hospital, Chengdu Sichuan, 610041, P.R.China.

Intensive Care Unit, Chengdu First People's Hospital, Chengdu Sichuan, 610041, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Mar 15;34(3):347-351. doi: 10.7507/1002-1892.201908098.

DOI:10.7507/1002-1892.201908098

PMID:32174081

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8171650/

Abstract

OBJECTIVE

To investigate the effectiveness of open reduction and internal fixation for multiple injuries of superior shoulder suspensory complex (SSSC) with coracoid process fracture.

METHODS

Between January 2014 and October 2018, 22 patients with multiple injuries of SSSC with coracoid process fracture were treated by open reduction and internal fixation. There were 16 males and 6 females, aged from 24 to 72 years with an average age of 36.6 years. There were 10 cases of falling injury, 5 cases of traffic accident injury, and 7 cases of falling from height injury. All of them were fresh closed injuries. The time from injury to operation ranged from 2 to 17 days with an average of 6.9 days. Both X-ray film and CT showed the coracoid process fracture complicated with clavicular fracture in 14 cases, acromioclavicular joint dislocation in 12 cases, and acromioclavicular fracture in 5 cases. There were 14 cases of two places of SSSC, 7 cases of three places of SSSC, and 1 case of four places of SSSC.

RESULTS

All incisions healed in primary stage after operation. All patients were followed up 10-24 months with an average of 14.1 months. X-ray films showed that all fractures healed and the acromioclavicular joint was normal. The healing time ranged from 6 to 12 months, with an average of 6.2 months. No complications such as internal fixation failure and nonunion occurred. According to University of California Los Angeles (UCLA) shoulder scoring system, the shoulder joint function was rated as excellent in 15 cases, good in 5 cases, and poor in 2 cases at last follow-up. The excellent and good rate was 90.9%.

CONCLUSION

Open reduction and internal fixation for treatment of multiple injuries of SSSC with coracoid process fracture is firm and reliable. Combined with active postoperative rehabilitation program intervention, it can accelerate the recovery of shoulder joint function and achieve satisfactory effectiveness.

摘要

目的

探讨切开复位内固定治疗肩锁关节上方悬吊复合体（SSSC）合并喙突骨折多发伤的疗效。

方法

2014年1月至2018年10月，对22例SSSC合并喙突骨折多发伤患者行切开复位内固定治疗。其中男性16例，女性6例，年龄24～72岁，平均36.6岁。坠落伤10例，交通事故伤5例，高处坠落伤7例。均为新鲜闭合伤。受伤至手术时间为2～17天，平均6.9天。X线片及CT显示，喙突骨折合并锁骨骨折14例，肩锁关节脱位12例，肩锁骨折5例。SSSC两处损伤14例，三处损伤7例，四处损伤1例。

结果

术后所有切口均一期愈合。所有患者均获随访，时间10～24个月，平均14.1个月。X线片显示骨折均愈合，肩锁关节正常。愈合时间6～12个月，平均6.2个月。未发生内固定失败、骨不连等并发症。末次随访时，根据美国加州大学洛杉矶分校（UCLA）肩关节评分系统，肩关节功能评定为优15例，良5例，差2例。优良率为90.9%。