Department of Orthopedic Trauma, First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.
Department of Orthopedic Trauma, First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China.
J Shoulder Elbow Surg. 2022 Jun;31(6):1175-1183. doi: 10.1016/j.jse.2021.12.008. Epub 2022 Jan 10.
Because of the irregular shape of the scapula and the different types of fractures, a standard internal fixation device is lacking in clinical practice, even though there are many options available. This study aimed to compare the therapeutic efficacy of titanium anatomic and reconstructive plates for extra-articular fractures of the scapula (Miller types IIb, IIc, and IV).
A retrospective study of 41 patients who underwent treatment for extra-articular fractures of the scapula between March 2017 and March 2020 was conducted. Patients were divided into 2 groups based on the fixation device: titanium anatomic plate group (20 patients) and titanium reconstructive plate group (21 patients). After follow-up for 12-18 months, the general characteristics, perioperative characteristics, postoperative follow-up findings, and imaging data of the 2 groups were compared.
The surgical procedures were uneventful in both groups. The anatomic plate group significantly outperformed the reconstructive plate group with respect to surgical duration and intraoperative blood loss (P < .001). At 3-month postoperative follow-up, the Constant-Murley score (P = .026), shoulder flexion range of motion, and shoulder abduction range of motion in the anatomic plate group were all significantly better than those in the reconstructive plate group (P < .001). The postoperative Western Ontario Shoulder Instability scores of the 2 groups were similar. Imaging showed functional recovery and stable and reliable fixation in both groups. Time to bone union was similar in both groups (9.10 ± 1.25 weeks in anatomic plate group and 9.24 ± 1.41 weeks in reconstructive plate group, P = .742). No complications occurred in any patient, such as fixation failure, instability, or bone nonunion.
Surgeons should favorably consider titanium anatomic plates for the treatment of extra-articular scapular fractures owing to their clear efficacy associated with a shorter surgical time, less intraoperative blood loss, better fixation, and rapid short-term functional recovery.
由于肩胛骨形状不规则和骨折类型多样，临床上缺乏标准的内固定装置，尽管有许多选择。本研究旨在比较钛解剖板和重建板治疗肩胛骨关节外骨折（Miller Ⅱ b、Ⅱ c 和 IV 型）的疗效。
回顾性分析 2017 年 3 月至 2020 年 3 月期间接受肩胛骨关节外骨折治疗的 41 例患者。根据固定装置将患者分为两组：钛解剖板组（20 例）和钛重建板组（21 例）。随访 12-18 个月后，比较两组患者的一般特征、围手术期特征、术后随访结果和影像学资料。
两组手术均顺利进行。解剖板组在手术时间和术中出血量方面明显优于重建板组（P<0.001）。术后 3 个月随访时，解剖板组的 Constant-Murley 评分（P=0.026）、肩关节活动度和肩关节外展活动度均明显优于重建板组（P<0.001）。两组术后 Western Ontario 肩不稳定评分相似。影像学显示两组均有功能恢复，固定稳定可靠。两组骨愈合时间相似（解剖板组为 9.10±1.25 周，重建板组为 9.24±1.41 周，P=0.742）。两组患者均未发生固定失败、不稳定或骨不愈合等并发症。
由于手术时间短、术中出血量少、固定效果好、短期功能恢复快，外科医生应优先考虑使用钛解剖板治疗肩胛骨关节外骨折。
