肩胛骨论文.docVIP

采用锁定钛板治疗肩胛骨骨折的疗效分析 牛勇 （山东新汶矿业集团中心医院骨一科 新泰市 271233） 摘要：[目的] 探讨分析锁定钛板内固定治疗肩胛骨骨折的疗效。[方法] 对11例肩胛骨骨折患者按骨折部位分为：体部爆裂骨折7例（合并肩胛岗骨折2例）；颈部骨折4例。所有患者均采用全身麻醉，健侧卧位。沿肩胛骨外缘做直切口，逐层切开，显露出肩胛骨的体部及颈部骨折处，清理骨折端，将骨折复位，于颈部或肩胛骨外缘放置锁定重建钛板，钻孔后拧入螺钉固定。肩胛骨中央的碎骨片因其极薄无法固定，按其形态摆放在原位即可，术中注意重建肩袖及软组织功能。术后患肢行前臂吊带外固定，加强肘、腕关节功能锻炼，术后4周去除吊带行主动功能锻炼。[结果] 术后所有患者均获随访，随访时间为11~18个月，所有病例骨折均愈合，愈合时间为3~4个月，无一例出现内固定物松动、断裂及骨折再移位，根据Hardegger肩关节功能评定标准，本组优7例，良3例，中1例，优良率为90.9%。[结论] 采用锁定钛板治疗肩胛骨骨折固定牢靠，螺钉松动的发生率极低；在操作中不必剥离骨膜，保护了局部血供，有利于骨折愈合，符合微创内固定原则。是治疗肩胛骨体部和颈部骨折的理想选择。 关键词: 锁定钛板; 内固定 ; 肩胛骨骨折 The analysis of the Curative Effect about the fracture of scapula after treating with locking plate // NIU Yong.Department of Orthopaedics,General Hospital of Xinwen Mineral Group,Xintai 271233,China Abstract: [Objective] To investigate the curative effect of the method of locking plate which was used in patients with fracture of scapula.[ Methods] 11 patients of fracture of scapula were divided into 2 groups according type of fracture，one group with 7 cases was bursting fracture of the body and combining 2 cases with the fracture of spine of scapula， the other group with 4 cases was the fracture of the neck . uninjured side position and general anesthesia was used in all patients. Straight incision was made along the exterior margin of the scapula, cut layer by layer and exposed the fracture positon of the body and neck of the scapula, cleaned and reduced the fracture .implanted locking plate on the neck or the exterior margin of scapula, fixed it with screws after drilling.then put the central bone cips in situ because it was too thin to fix. We should reconstruct the rotator cuff and soft tissue to ensure the function. After operation, the affected limb should be fixed with forearm sling,and moved the elbow joint and wrist joint frequently. Removed the sling afer 4 weeks and do more initiative action with affected limb. [Results] All patients were followed up and the time was 11-18 months ,then we found the fracture was all union af