Zhang Jianping, Liu Hui, Xu Weizhen, Xiong Yuanfei, Zhang Jinhui, Wu Jin
Department of Orthopaedics, Joint Support Force 909th Hospital of Chinese PLA, Southeast Hospital of Xiamen University, Zhangzhou Fujian, 363000,P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Nov 15;37(11):1375-1379. doi: 10.7507/1002-1892.202308005.
To investigate the effectiveness of compression screw combined with Buttress plate through direct axillary approach for Ideberg typeⅡ scapular glenoid fractures.
A retrospective analysis was conducted on 11 patients with Ideberg type Ⅱ scapular glenoid fractures treated with compression screws combined with Buttress plate fixation through the direct axillary approach between January 2014 and June 2022. There were 7 males and 4 females, aged from 34 to 75 years, with an average of 56.0 years. The causes of injury included 4 cases of falling from height injury, 4 cases of heavy object injury, and 3 cases of traffic accident injury. The time from injury to operation was 2-5 days, with an average of 3.8 days. The operation time, intraoperative blood loss, hospital stay, complications, and fracture healing time were recorded. The Constant-Murley score, American Society of Shoulder and Elbow Surgeons (ASES) score, and shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion were used to evaluate shoulder joint pain and function.
The operation time was 45-105 minutes, with an average of 79.0 minutes; the intraoperative blood loss was 80-200 mL, with an average of 99.2 mL; the hospital stay was 3-8 days, with an average of 5.8 days. One patient had poor wound healing after operation, and the wound healed after strengthening dressing change; the rest wounds had primary healing, and no axillary nerve paralysis occurred. Except for 1 patient lost follow-up, the remaining 10 patients were followed up 10-54 months, with an average of 26.4 months. The postoperative X-ray film examination showed that the fractures healed well within 8-15 weeks, with an average of 11.0 weeks. There was no complication such as fracture displacement, internal fixator failure or fracture during follow-up. At last follow-up, the patient's shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion, Constant-Murley score, and ASES score significantly improved when compared with those before operation ( <0.05).
Compression screw combined with Buttress plate through direct axillary approach is an effective way to treat Ideberg typeⅡ scapular glenoid fracture, with advantages of small trauma, concealed incision, and good effectiveness.
探讨采用直接腋路入路，应用加压螺钉联合支撑钢板治疗IdebergⅡ型肩胛盂骨折的疗效。
回顾性分析2014年1月至2022年6月采用直接腋路入路，应用加压螺钉联合支撑钢板固定治疗的11例IdebergⅡ型肩胛盂骨折患者。其中男性7例，女性4例，年龄34～75岁，平均56.0岁。致伤原因包括高处坠落伤4例，重物砸伤4例，交通事故伤3例。受伤至手术时间为2～5天，平均3.8天。记录手术时间、术中出血量、住院时间、并发症及骨折愈合时间。采用Constant-Murley评分、美国肩肘外科医师学会（ASES）评分以及肩关节前屈、外展、外旋（中立位）和内旋（中立位）活动度评估肩关节疼痛及功能。
手术时间45～105分钟，平均79.0分钟；术中出血量80～200毫升，平均99.2毫升；住院时间3～8天，平均5.8天。1例患者术后伤口愈合不佳，加强换药后伤口愈合；其余伤口均一期愈合，未发生腋神经麻痹。除1例患者失访外，其余10例患者随访10～54个月，平均26.4个月。术后X线片检查显示骨折在8～15周内愈合良好，平均11.0周。随访期间未出现骨折移位、内固定失败或骨折不愈合等并发症。末次随访时，患者肩关节前屈、外展、外旋（中立位）和内旋（中立位）活动度、Constant-Murley评分及ASES评分与术前相比均显著改善（<0.05）。
采用直接腋路入路，应用加压螺钉联合支撑钢板治疗IdebergⅡ型肩胛盂骨折是一种有效的方法，具有创伤小、切口隐蔽、疗效好等优点。
