The classification and operative treatment of scapular fractures
- VernacularTitle:肩胛骨骨折的分类及手术治疗
- Author:
Jian JIA
- Publication Type:Journal Article
- Keywords:
Scapula;
Shoulder fracture;
Diagnosis;
Freature fixation, internal;
Treatment outcome
- From:
Chinese Journal of Orthopaedics
2000;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the early diagnosis and surgical treatment of scapular fractures. Methods Sixteen cases with scapular fractures received operation that had been admitted to our hospital from January 1996 to January 2001 were retrospectively analyzed. AP views of X-ray, two-dimensional CT scannings and three-dimensional CT reconstructions were used to confirm the injuries. According to Hardegger's classification for scapular fractures, There were 9 fractures of the scapular body, 7 fractures of the scapular neck, 2 fractures of the glenoid rim, 1 fracture of the glenoid fossa, 5 fractures of the scapular spine, 3 fractures of the acromion and 2 fractures of the coracoid process. Of the 16 patients, 11(68.8%) cases had complex fractures of the scapula, and 14 cases (87.5%) had associated injuries. On the basis of the fracture patterns, anterior, posterior, posterosuperior approach,and anterior combined posterior approach were performed with plates or(and) lag screws for surgical reconstruction. Results All patients were followed up with an average of 18.6 months. According to Rowes evaluation, 11 cases showed excellent results, 2 good, 1 fair, and 2 poor. The glenohumeral posttraumatic arthritis of the series was found in 2 cases, heterotopic ossification in 1 case, and shoulder joint instability in 1 case. Conclusion 1) Scapular fractures are caused by high-energy violence with a high incidence of serious associated injury. Computerized tomography scanning with three-dimensional imaging is helpful to determine the fracture pattern and degree of displacement; 2) Intra-articular fracture of the glenoid fossa with more than 3 to 5 mm of step-off displacement, the glenoid rim fracture combined with humeral head subluxation, grossly displaced fracture of the scapular neck, some bursting fractures of the body, and floating shoulder injuries should be operated; 3) Open reduction and internal fixation is an useful and safe technique for the treatment of specific displaced fractures of the scapula. It needs at least 12 months to determine the final functional result.
