摘要
目的:探讨非手术与手术治疗肩胛骨骨折的疗效并进行分析比较。方法:肩胛骨骨折患者52例,男37例,女15例;年龄20～48岁,平均31岁。对其临床资料进行回顾性对比分析。根据Hardegger分型:肩胛骨体部骨折24例,外科颈骨折12例,解剖颈骨折3例,盂缘骨折6例,肩胛冈骨折7例。其中17例采用保守治疗;35例采用切开复位内固定治疗。随访时进行临床检查,摄肩胛骨正位X线片,测量盂极角(glenopolarangle,GPA)。并采用Hardegger功能评定标准对两种治疗方法的疗效进行统计学比较分析。结果:52例均经9～48周随访。Hardegger功能评定:非手术治疗组17例,优7例,良6例,可2例,差2例;GPA>20°14例,<20°3例。手术组35例,优20例,良12例,可3例;GPA>20°33例,<20°2例。非手术组与手术组的治疗结果预后差异无统计学意义(P=0.27)。结论:处理肩胛骨骨折之前,首先行CT三维重建,全面了解骨折移位情况,正确掌握手术适应证,并进行早期功能锻炼,两种方法均可获得满意疗效。
Objective. To investigate the effect of treatment methods of non-operation and surgical operation for scapular fracture. Methords ：A retrospective analysis of 52 patients （male 37, female 15, ranging in age from 20 to 48 years, meanly 31 years）with scapular fractures was done. According to Hardegger classification：the scapular body fracture in 24 cases, the surgical neck fracture in 12 cases ,the anatomical neck fracture in 3 cases,the glenoidal lip fracture in 6 cases,the scapular spine fracrnre in 7 cases. Of all 52 patients, 17 cases were treated conservatively,and 35 were undergone surgical internal fixation. When followed up,the clinical examination was done and the X-ray films were taken to measure glenopolar angle （GPA）. Hardegger function evaluation system was adopted. The results were analysed statiscally. Results. Fifty-two cases were all followed up for 9 weeks to 48 months. Among 17 patients treated by non-operation,Hardegger function evaluation system showed that the result were excellent in 7 cases, good in 6,fair in 2 and poor in 2 ;the X-ray film results showed that there were 14 cases of GPA 〉20° and 3 cases of GPA 〈20°. Of 35 patients treated by surgical operation, Hardegger function evaluation system showed that the result were excellent in 20 cases, good in 12 and fair in 3 ; the X-ray film results showed that there were 33 cases of GPA〉20° and 2 cases of GPA〈20°. There was no significant difference between the two groups （P=0.27）. Conclusion： Before treatment of scapular fracture, with CT 3D-recontruction ,complete understanding of fragments displacement,and correction indication selection, and perform early exercises, both of the two procedures can provide satisfactory outcome.
出处
《中国骨伤》
CAS
2008年第2期91-93,共3页
China Journal of Orthopaedics and Traumatology
关键词
肩胛骨
骨折
骨折固定术
临床对照试验
Scapular
Fractures
Fracture fixation
Controlled clinical trials
