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肩胛骨折的内固定治疗:一项回顾性队列研究。

Osteosynthesis of scapular fractures: a retrospective cohort study.

机构信息

Department of Surgery, Division of Trauma Surgery, Cantonal Hospital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland.

Department of Trauma Surgery, Northwest Hospital Group, Alkmaar, Netherlands.

出版信息

Arch Orthop Trauma Surg. 2022 Dec;142(12):3845-3852. doi: 10.1007/s00402-021-04283-3. Epub 2022 Jan 7.

Abstract

PURPOSE

In recent years a trend from conservative to operative treatment of displaced scapula fractures has evolved. The aim of this study was to assess surgical and patient-based radiological and functional outcome after open reduction and internal fixation (ORIF) of displaced scapula fractures following predefined operative indications.

METHODS

We retrospectively analyzed data of a consecutive series of patients with displaced scapula fractures following operative fixation at our institution between 06/2010 and 02/2020. The primary endpoint was a functional outcome using the QuickDASH score. Secondary outcomes were the Subjective Shoulder Value (SSV), numeric rating scale (NRS) for pain, Activities of Daily Living score (ADL) and complications.

RESULTS

Twenty-six male patients were treated operatively. Twenty-three of whom were available for follow-up after a median follow-up time of 33 months (interquartile range [IQR] 8-70 months). In 18 (69%) cases a standard open approach and in 8 (31%) cases a minimal invasive (MI) approach was used. The median QuickDASH was 0 (IQR 0-0) with a median SSV of 95 (IQR 90-98). Patients reported a median NRS of 0 (IQR 0-1) and a median ADL score of 1 (IQR 1-1). Radiological fracture union was 100% without the occurrence of implant failure or mal-union. Two patients (7.7%) required early correction osteosynthesis, one patient (3.8%) developed a frozen shoulder 3 months postoperatively, and one patient (3.8%) presented with a superficial wound infection.

CONCLUSION

Following previously published indications for ORIF of displaced scapula body and neck fractures a good functional outcome and a low rate of complications could be achieved.

摘要

目的

近年来,从保守治疗向手术治疗移位肩胛骨骨折的趋势已经出现。本研究的目的是评估根据既定手术适应证对移位肩胛骨骨折进行切开复位内固定(ORIF)后的手术和基于患者的放射学及功能结果。

方法

我们回顾性分析了 2010 年 6 月至 2020 年 2 月期间我院接受手术固定的连续系列移位肩胛骨骨折患者的数据。主要终点是使用 QuickDASH 评分评估功能结果。次要结果包括主观肩部值(SSV)、疼痛数字评分量表(NRS)、日常生活活动评分(ADL)和并发症。

结果

26 名男性患者接受了手术治疗。其中 23 名在中位随访 33 个月(四分位距 [IQR] 8-70 个月)后可获得随访。18 例(69%)采用标准开放式入路,8 例(31%)采用微创(MI)入路。QuickDASH 的中位数为 0(IQR 0-0),SSV 的中位数为 95(IQR 90-98)。患者报告的 NRS 中位数为 0(IQR 0-1),ADL 评分中位数为 1(IQR 1-1)。影像学骨折愈合率为 100%,无植入物失败或畸形愈合发生。2 名患者(7.7%)需要早期矫正性骨合成,1 名患者(3.8%)术后 3 个月发生冻结肩,1 名患者(3.8%)出现浅表伤口感染。

结论

根据先前发表的关于移位肩胛骨体部和颈部骨折 ORIF 的适应证,可获得良好的功能结果和较低的并发症发生率。

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