Lehmann L-J, Schmalzl J
Klinik für Unfall‑, Handchirurgie und Sportmedizin, ViDia Kliniken Karlsruhe, Steinhäuserstr. 18, 76135, Karlsruhe, Deutschland.
Klinik und Poliklinik für Unfall‑, Hand‑, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.
Unfallchirurgie (Heidelb). 2024 Jan;127(1):69-78. doi: 10.1007/s00113-023-01397-8. Epub 2024 Jan 4.
Scapular fractures are rare injuries that require different treatment strategies. Nondisplaced fractures and the majority of scapular body fractures can be treated conservatively, while surgical treatment should be considered for displaced fractures involving the glenoid. Displaced glenoid fractures of appropriate size and intra-articular step formation should be treated surgically. Different classification systems for scapular fractures can support the treatment decision. Postoperative and posttraumatic management should include early mobilization to achieve a good functional outcome. Clear recommendations and treatment algorithms at the evidence level are not available and long-term outcomes of scapular fractures are the subject of further investigation. The results published so far show good to excellent results for surgical and conservative treatment, depending on the type of fracture. Individual patient factors should be considered when planning treatment.
肩胛骨折是罕见的损伤,需要不同的治疗策略。无移位骨折和大多数肩胛体骨折可采用保守治疗,而涉及关节盂的移位骨折则应考虑手术治疗。大小合适且有关节内台阶形成的移位关节盂骨折应进行手术治疗。肩胛骨折的不同分类系统有助于治疗决策。术后和创伤后的处理应包括早期活动,以获得良好的功能结果。目前尚无基于证据的明确建议和治疗方案,肩胛骨折的长期预后仍是进一步研究的课题。迄今为止发表的结果表明,根据骨折类型,手术和保守治疗均能取得良好至优异的效果。制定治疗方案时应考虑个体患者因素。