Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Piazzetta Filippo Muratore, Block: A- Floor:V, 73100 Lecce, Italy.
Department of Orthopaedics and Traumatology, Hacettepe University Hospital, Ankara, Turkey.
Injury. 2021 Mar;52(3):481-486. doi: 10.1016/j.injury.2020.09.006. Epub 2020 Sep 14.
Scapular body fractures represent less than 1% of all skeletal fractures. Operative criteria and risk factors for scapular fracture instability are well defined. Non-operative management of scapular body fractures show satisfactory results but with shortening and medialization of the scapular body. The aim of this study is to evaluate if surgical treatment will result in an improved quality of life and shoulder function compared to non-operative treatment on patients suffering from a scapular body fracture.
From a total of 381 retrospectively identified scapular body fractures, we included 45 patients. The enrolled patients were divided into two groups: the surgical treatment (ST, n = 20) group and the non-operative treatment (NOT, n = 25) group. The Non-Union Scoring System (NUSS) was used to assess bone healing on radiographs. The functional evaluation of the two groups during the follow-up were performed using the Constant Shoulder Score (CSS) and the Quick Disabilities of the Arm, Shoulder and Hand Score (QuickDASH). Complications, reoperation rates, and time until bony union were also documented. The minimum follow-up for this study was designated as 12 months.
The ST group had better mean CSS and QuickDASH scores compared to the NOT group at 1, 3 and 6 months of follow-up. No statistically significant difference was detected at 12 months follow-up. ST group also demonstrated improved results in time until bone union, reduction of rehabilitation time, complications and return to work rates.
This study suggests that surgical treatment for extraarticular scapular fractures can achieve better short-term functional outcomes (3 to 6 months) compared to conservative treatment.
肩胛骨体部骨折占所有骨骼骨折的比例不到 1%。肩胛骨骨折不稳定的手术标准和危险因素已经明确。肩胛骨体部骨折的非手术治疗可获得满意的结果,但会导致肩胛骨体缩短和内移。本研究旨在评估手术治疗与非手术治疗相比,是否会改善肩胛骨体骨折患者的生活质量和肩部功能。
从总共 381 例回顾性确定的肩胛骨体部骨折中,我们纳入了 45 例患者。将纳入的患者分为两组:手术治疗(ST)组(n=20)和非手术治疗(NOT)组(n=25)。使用非愈合评分系统(NUSS)评估影像学上的骨愈合情况。在随访期间,使用 Constant 肩部评分(CSS)和快速上肢肩手功能障碍评分(QuickDASH)对两组的功能进行评估。还记录了并发症、再次手术率和骨愈合时间。本研究的最小随访时间为 12 个月。
在 1、3 和 6 个月的随访中,ST 组的平均 CSS 和 QuickDASH 评分均优于 NOT 组。在 12 个月的随访中,两组无统计学差异。ST 组在骨愈合时间、康复时间、并发症和重返工作率方面也显示出更好的结果。
本研究表明,对于关节外肩胛骨骨折,手术治疗可获得比保守治疗更好的短期功能结果(3-6 个月)。