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X 射线和 CT 扫描在 Goss-Ideberg Ⅲ型肩盂骨折小切口复位与上方闭合穿针固定中的早期临床疗效

Early Clinical Efficacy of Small Incision Reduction and Superior Closed Pin Fixation of Goss-Ideberg Type III Glenoid Fractures using X-ray and CT Scan.

机构信息

Department of Orthopedic Surgery, Jinan Central Hospital Affiliated to Shandong First Medical University, Jinan 250013, China.

出版信息

Curr Med Imaging. 2024;20:e15734056279954. doi: 10.2174/0115734056279954240304051622.

DOI:10.2174/0115734056279954240304051622
PMID:39087571
Abstract

BACKGROUND

Imaging techniques such as X-rays and 3D Computed Tomography (CT) are used to diagnose and evaluate a patient's shoulder before and after surgery. Identifying the kind, location, and severity of a shoulder fracture helps surgeons choose the right treatment and surgery.

OBJECTIVES

The study examines the effectiveness of small incision reduction and superior closure pinning in treating Ideberg type III glenoid fractures identified by X-ray and CT scans.

MATERIALS AND METHODS

From October 2017 to June 2022, 40 patients with Ideberg type III glenoid fractures underwent mini-incision reduction and superior closed pinning fixation using the Anterior (AA) and Posterior (PA) approaches. Pre- and post-surgery shoulder scores and imaging data were analyzed. Outpatient review and shoulder anteroposterior radiographs were collected at 1, 3, 6, and 12 months after surgery. We assessed shoulder joint function using the American Shoulder and Elbow Society (ASES) shoulder score, VAS score, Constant-Murley Shoulder Outcome (Constant) score, and DASH score.

RESULTS

A total of 40 patients were monitored for 14-16 months, averaging 15.2 ± 0.3 months. All fractures were healed between 14-25 weeks from X-rays, averaging 17.6 ± 5.4 weeks. Both the AA and PA groups had similar shoulder score changes. However, the AA group did better. In all cases, ASES shoulder scores were outstanding at 80%. Radiographs demonstratedno traumatic arthritis or internal fixation failure consequences like screw loosening or breakage.

CONCLUSION

It was concluded that Ideberg type III glenoid fracture reduction with an anterior small incision and superior closed pinning hollow lag screw internal fixation could be successful.

摘要

背景

X 射线和 3D 计算机断层扫描(CT)等成像技术用于在手术前后诊断和评估患者的肩部。确定肩部骨折的类型、位置和严重程度有助于外科医生选择正确的治疗和手术方法。

目的

本研究检查了小切口复位和上封闭钉治疗 X 射线和 CT 扫描确定的 Ideberg Ⅲ型肩胛盂骨折的效果。

材料和方法

2017 年 10 月至 2022 年 6 月,40 例 Ideberg Ⅲ型肩胛盂骨折患者采用前(AA)和后(PA)入路行小切口复位和上封闭钉固定。分析术前和术后肩部评分和影像学资料。术后 1、3、6 和 12 个月收集门诊复查和肩部前后位 X 线片。我们使用美国肩肘协会(ASES)肩部评分、视觉模拟评分(VAS)、Constant-Murley 肩部结果(Constant)评分和 DASH 评分评估肩关节功能。

结果

共 40 例患者接受了 14-16 个月的监测,平均 15.2±0.3 个月。所有骨折均在 X 线片上 14-25 周愈合,平均为 17.6±5.4 周。AA 组和 PA 组的肩部评分变化相似,但 AA 组效果更好。所有病例的 ASES 肩部评分均为 80%,非常出色。X 线片显示无创伤性关节炎或内固定失败,如螺钉松动或断裂。

结论

采用前小切口和上封闭钉空心拉力螺钉内固定治疗 Ideberg Ⅲ型肩胛盂骨折是成功的。

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