Department of Traumatology, Sestre milosrdnice University Hospital Center, Draškovićeva 19, 10000 Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia.
Department of Traumatology, Sestre milosrdnice University Hospital Center, Draškovićeva 19, 10000 Zagreb, Croatia.
Injury. 2021 Sep;52 Suppl 5:S38-S43. doi: 10.1016/j.injury.2020.09.031. Epub 2020 Sep 16.
The aim of this study was to describe a surgical technique and report on patient-based functional outcomes and complications following open reduction and internal fixation in patients with scapular fractures.
The study comprised 14 patients who were treated with open reduction and internal fixation (ORIF) of a scapular fractures between September 2010 and July 2018. Surgical indications were as follows: medial/lateral displacement greater than 20 mm; shortening greater than 25 mm; angular deformity greater than 40°; intra-articular step-off greater than 4 mm; and double shoulder suspensory injuries (including fracture of the clavicle, coracoid or acromion with displacement greater than 10 mm). All patients underwent X-ray examination (true AP, Y scapular view) and computed tomography (CT) scans. Fractures were classified according to the revised (AO/OTA) classification system. Functional outcomes were measured using Constant-Murley scores.
Seven patients had glenoid fossa fractures, six patients had scapular body fractures and one patient had an acromion process fracture. All glenoid fossa and scapular body fractures were exposed via the Judet approach. Eleven of 14 patients were given Constant-Murley scores at the final follow-up examination; three patients were lost to follow-up. The mean follow-up after injury was 44 months (range, 6-92 months). We found infraspinatus muscle hypotrophy in four patients. The mean Constant-Murley score was 93.45 (±8.93) for the injured arm and 98.36 (±2.91) for the uninjured arm. The mean score between the injured and uninjured arm was 4.91(±6.49), which is an excellent functional outcome according to the Constant-Murley score.
Open reduction and internal fixation of displaced scapular fractures is a safe and effective treatment option that results in a reliable union rate and good-to-excellent functional outcome.
本研究的目的是描述一种手术技术，并报告接受切开复位内固定术（ORIF）治疗的肩胛骨骨折患者的基于患者的功能结果和并发症。
本研究纳入了 2010 年 9 月至 2018 年 7 月期间接受切开复位内固定术（ORIF）治疗的 14 例肩胛骨骨折患者。手术指征如下：内侧/外侧移位大于 20mm；缩短大于 25mm；成角畸形大于 40°；关节内台阶大于 4mm；双肩部悬吊损伤（包括锁骨、喙突或肩峰骨折，且移位大于 10mm）。所有患者均接受 X 线检查（真前后位、Y 肩胛骨位）和计算机断层扫描（CT）检查。骨折根据修订后的（AO/OTA）分类系统进行分类。使用 Constant-Murley 评分测量功能结果。
7 例患者为关节盂窝骨折，6 例患者为肩胛骨体骨折，1 例患者为肩峰骨折。所有关节盂窝和肩胛骨体骨折均通过 Judet 入路暴露。14 例患者中有 11 例在最终随访时接受了 Constant-Murley 评分，3 例失访。受伤后平均随访时间为 44 个月（6-92 个月）。我们发现 4 例患者的冈下肌萎缩。受伤侧的平均 Constant-Murley 评分为 93.45（±8.93），未受伤侧为 98.36（±2.91）。受伤侧和未受伤侧的平均评分差值为 4.91（±6.49），根据 Constant-Murley 评分，这是一个极好的功能结果。
切开复位内固定治疗移位的肩胛骨骨折是一种安全有效的治疗选择，可获得可靠的愈合率和良好至极好的功能结果。
