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肩胛骨关节骨折的手术治疗结果

RESULTS OF THE SURGICAL TREATMENT OF ARTICULAR SCAPULAR FRACTURES.

作者信息

Terra Bernardo Barcellos, Sassine Tannous Jorge, Pinheiro João Victor Rezende Soares, Lopes Matheus Alberto Nunes, Sousa Dhyego Bonelle DE, Amorim Vinicius Souza

机构信息

Hospital Santa Casa de Vitória, Departamento de Ortopedia, Grupo de Trauma do Esporte, Vitória, ES, Brazil.

Hospital Santa Casa de Vitória, Departamento de Ortopedia e Traumatologia, Vitória, ES, Brazil.

出版信息

Acta Ortop Bras. 2022 Aug 26;30(4):e247095. doi: 10.1590/1413-785220223004e247095. eCollection 2022.

Abstract

INTRODUCTION

Scapular fractures are rare injuries and are often associated with high-energy trauma, with joint fractures accounting for only 15% of all scapular fractures. Surgical treatment is indicated for fractures with large deviations and with joint instability.

OBJECTIVE

This study evaluates the clinical and functional results after surgical treatment of scapular fractures.

METHODS

Eight patients with scapular fractures were surgically treated between 2013 and 2019. For indication for surgical treatment, mediolateral deviations, glenopolar angle, angular deviations and joint deviations greater than 4 mm were taken into account. Radiographic results of consolidation, range of motion, functional score and visual analogue pain scale were obtained.

RESULTS

In the mean follow-up of twenty-nine months (13-40 months), all patients presented fracture consolidation. The mean UCLA score was 29 points (with 75% good results and 25% moderate results). Regarding the range of motion, the mean elevation was 146° (ranging from 110° to 60°), lateral rotation of 62° (36-80°) and medial rotation at the level of T7 (T6-T10). The final VAS mean was 2.3. All patients returned to the pre-injury level at work.

CONCLUSION

In this series of cases, surgical treatment of scapular articular fractures provided satisfactory results with low rates of complications, showing to be an option in selected cases of deviated fractures.

摘要

引言

肩胛骨折是罕见损伤,常与高能量创伤相关,关节骨折仅占所有肩胛骨折的15%。对于有明显移位和关节不稳定的骨折,需进行手术治疗。

目的

本研究评估肩胛骨折手术治疗后的临床和功能结果。

方法

2013年至2019年间,对8例肩胛骨折患者进行了手术治疗。手术治疗的指征考虑了内外侧移位、肩胛极角、角移位和大于4mm的关节移位。获得了骨折愈合的影像学结果、活动范围、功能评分和视觉模拟疼痛量表。

结果

平均随访29个月(13 - 40个月),所有患者均骨折愈合。平均加州大学洛杉矶分校(UCLA)评分为29分(75%为良好结果,25%为中等结果)。关于活动范围,平均抬高为146°(范围为110°至60°),外旋为62°(36 - 80°),内旋在T7水平(T6 - T10)。最终视觉模拟评分(VAS)平均值为2.3。所有患者均恢复到伤前的工作水平。

结论

在这一系列病例中,肩胛关节骨折的手术治疗取得了满意的结果,并发症发生率低,表明在选定的移位骨折病例中是一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a259/9425968/bb5a854b5618/1809-4406-aob-30-04-e247095-gf1.jpg

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