Thompson D A, Flynn T C, Miller P W, Fischer R P
J Trauma. 1985 Oct;25(10):974-7. doi: 10.1097/00005373-198510000-00008.
Scapular fractures in the multiply injured patient have received little attention. Fifty-six patients with 58 scapular fractures secondary to blunt trauma were reviewed. The patients averaged 3.9 major injuries excluding their scapular fractures. The injury pattern associated with blunt scapular fracture is unique. Patients with scapular fracture have a high incidence of injury to the ipsilateral lung and chest wall and to the ipsilateral shoulder girdle and its contained structures: rib fractures, 53.6%; pulmonary contusions, 53.6%; clavicular fracture, 26.8%; brachial plexus injury, 12.5%; subclavian, brachial, or axillary artery injury, 10.7%. Eight patients died (14.3%). Although no patient died from the scapular fracture, half of the deaths in this series were the result of pulmonary sepsis arising in an associated ipsilateral pulmonary contusion. Scapular fractures provide the trauma surgeon with a reliable clinical clue that the patient is at inordinate risk to have associated injuries of major consequence to the ipsilateral lung and chest wall, the ipsilateral shoulder girdle, and the ipsilateral subclavian, axillary, or brachial artery.
多发伤患者的肩胛骨骨折很少受到关注。我们回顾了56例继发于钝性创伤的58处肩胛骨骨折患者。这些患者平均有3.9处严重损伤（不包括肩胛骨骨折）。与钝性肩胛骨骨折相关的损伤模式是独特的。肩胛骨骨折患者同侧肺和胸壁、同侧肩胛带及其所含结构损伤的发生率很高：肋骨骨折53.6%；肺挫伤53.6%；锁骨骨折26.8%；臂丛神经损伤12.5%；锁骨下、肱或腋动脉损伤10.7%。8例患者死亡（14.3%）。虽然没有患者死于肩胛骨骨折，但该系列中一半的死亡是由同侧相关肺挫伤引起的肺部感染所致。肩胛骨骨折为创伤外科医生提供了一个可靠的临床线索，提示患者同侧肺和胸壁、同侧肩胛带以及同侧锁骨下、腋或肱动脉有发生严重相关损伤的极高风险。
