Jaikish S, Sambandam Balaji
Atlas Hospitals, First cross, V.N. Nagar, Trichy, 620002 Tamil Nadu India.
Indian J Orthop. 2020 Oct 31;55(3):708-713. doi: 10.1007/s43465-020-00297-y. eCollection 2021 Jun.
Scapular fractures are uncommon injuries of upper extremity resulting mostly from high-energy trauma. Extra-articular fractures form the majority of them. Un-displaced fractures can be managed conservatively with good results. But displaced fracture does not yield satisfactory results and needs surgical fixation. In this case series, we report our experience about such fractures.
This was a retrospective study of 12 patients with displaced scapular body and neck fractures treated between 2015 and 2018. Scapular fractures were exposed by modified Judet approach and fixed with either 3.5 mm T buttress or recon locking plate and screws. One case had associated clavicle fracture which was fixed along with scapula. Patients were put on structured rehabilitation and followed up regularly. Functional outcome and range of motion were analyzed.
The patients included 10 males and two females. Mean age was 42 years. Average follow-up was 33 months. Average constant and Murley score was 80. Excellent results were seen in four patients, good results in seven patients and one patient has got fair result. The mean post-operative range of motion of the shoulder at the time of final follow-up was 140° of forward flexion, 136° of abduction, and 34° of external rotation.
Displaced extra-articular scapular fractures managed by internal fixation using T buttress locking plates and reconstruction plates give good functional outcome.
肩胛骨骨折是上肢的罕见损伤，主要由高能创伤引起。关节外骨折占大多数。无移位骨折可采用保守治疗，效果良好。但移位骨折的治疗效果不理想，需要手术固定。在本病例系列中，我们报告了我们对此类骨折的治疗经验。
这是一项对2015年至2018年间治疗的12例肩胛骨体部和颈部移位骨折患者的回顾性研究。采用改良Judet入路暴露肩胛骨骨折，并用3.5毫米T形支撑钢板或重建锁定钢板及螺钉固定。1例合并锁骨骨折，与肩胛骨一并固定。患者接受结构化康复治疗并定期随访。分析功能结果和活动范围。
患者包括10名男性和2名女性。平均年龄为42岁。平均随访33个月。Constant和Murley平均评分为80分。4例患者结果优秀，7例患者结果良好，1例患者结果尚可。末次随访时肩部的平均术后活动范围为前屈140°、外展136°和外旋34°。
采用T形支撑锁定钢板和重建钢板内固定治疗移位的关节外肩胛骨骨折，功能结果良好。
