摘要
目的探讨浮肩损伤的发病机制、临床特点及手术治疗策略。方法笔者回顾分析2005年5月-2014年3月期间经手术治疗的浮肩损伤25例（男性19例,女性6例;年龄22-61岁,平均41.7岁）,其中行单纯锁骨骨折或肩锁关节脱位内固定14例,联合固定肩胛颈（盂）11例,根据手术前后Constant-Murley评分（CMS）及前后盂极角（GPA）的变化对患者的疗效进行评价。结果 25例随访6-24个月,平均12.7个月;25例术前CMS（64.0±8.4）分,末次随访时CMS（89.3±7.2）分,其改善有统计学意义（P〈0.05）。术前GPA为（20.6±5.9）°,末次随访GPA为（34.6±3.6）°,显示经过手术治疗GPA改善明显（P〈0.05）。锁骨固定组与联合固定组术前GPA、肩胛颈（盂）的移位、成角数值有统计学差异（P〈0.05）,两组末次随访GPA及CMS无统计学差异（P〉0.05）。结论早期手术治疗可稳定肩关节上方悬吊体,恢复肩胛颈的解剖结构,疗效满意,手术方式应结合患者肩胛颈的移位、旋转角度及GPA值等个体化制定。
Objective To investigate the mechanism,clinical characteristics and operative treatment strategy of floating shoulder injuries（ FSI）. Methods Clinical data of 25 patients with FSI[19 males and 6 females with an average age of 41. 7（ 22-61） years] admitted to our hospital from May 2005 to Mar. 2014 were retrospectively reviewed. Of the 25 cases with open reduction,14 cases had internal fixation of only clavicle or acromioclavicular joint,and 11 cases had internal fixation of both clavicle and glenoid. The glenopolar angle（ GPA） was measured preoperatively and during the late followed-up. All data was rated according to Constant and Murley Score（ CMS）. Results All patient were followed up for an average of 12. 7（ 6-24） months,which showed that GPA was corrected from（ 20. 6 ± 5. 9） ° to（ 34. 6 ± 3. 6） ° at the last follow-up and CMS was increased from preoperative（ 64. 0 ± 8. 4） before the operations to（ 89. 3 ± 7. 2） at the last follow-up. There were statistical differences between the two groups in GPA and CMS（ P 〈0. 01）,while GPA and CMS during the follow-up did not differ statistically（ P 〉0. 05）. Conclusion Early surgical treatment of FSI can stabilize the superior suspensory shoulder complex（ SSSC） and restore anatomical structure of the glenoid. Proper surgical treatment strategy should be selected according to individual situation,including the medial displacement of the glenoid,the GPA,and the inclination angle of the glenoid.
出处
《创伤外科杂志》
2015年第6期501-506,共6页
Journal of Traumatic Surgery
关键词
锁骨骨折
浮肩损伤
肩胛颈
内固定
clavicle fracture
floating shoulder injuries
glenoid
internal fixation
