Mayo K A, Benirschke S K, Mast J W
Department of Orthopaedic Surgery, Wayne State University School of Medicine, Detroit, MI 48092, USA.
Clin Orthop Relat Res. 1998 Feb(347):122-30.
Displaced fractures of the glenoid fossa are an uncommon and anatomically diverse group of injuries. Failure to restore anatomy in these fractures results in poor outcome in most cases. The success of a treatment protocol that encompasses appropriate preoperative imaging, injury pattern assessment, prudent approach choice, and a comprehensive reduction and fixation tactic was evaluated. Twenty-seven patients were assessed clinically and radiographically at a mean followup interval of 43 months from surgery. Anatomic reconstruction was achieved in 24 (89%) patients. Three patients had residual joint incongruities measuring 2 mm or less. The only perioperative complication was a partial superficial wound dehiscence. Two additional patients had infraspinatus palsies of indeterminate origin. Functional rating revealed six (22%) excellent, 16 (60%) good, three (11%) fair, and two (7%) poor outcomes. The fair and poor outcomes largely were related to associated injuries. These findings show that anatomic surgical reconstruction with a low complication rate and good functional outcome can be obtained for most patients with glenoid fossa fractures.
肩胛盂移位骨折是一组少见且解剖结构多样的损伤。在这些骨折中未能恢复解剖结构在大多数情况下会导致预后不良。评估了一种治疗方案的效果，该方案包括适当的术前影像学检查、损伤模式评估、谨慎的方法选择以及全面的复位和固定策略。27例患者在术后平均43个月时接受了临床和影像学评估。24例（89%）患者实现了解剖重建。3例患者存在2毫米或更小的残余关节不匹配。唯一的围手术期并发症是部分表浅伤口裂开。另外2例患者出现了原因不明的冈下肌麻痹。功能评分显示，6例（22%）为优，16例（60%）为良，3例（11%）为可，2例（7%）为差。可和差的结果在很大程度上与相关损伤有关。这些发现表明，大多数肩胛盂骨折患者通过解剖手术重建可获得低并发症率和良好的功能结果。
