[1]陈长青△ 周影 王耀生 王成 陈峥龙 林灿斌.微创手术入路与Judet入路治疗肩胛骨骨折的对比研究[J].中国中医骨伤科杂志,2016,24(10):9-12.
　CHEN Changqing ZHOU Ying WANG Yaosheng WANG Cheng CHEN Zhenglong LIN Canbin.Comparative Study on the Scapular Fracture by Minimally InvasiveSurgical Approach and Judet Approach[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2016,24(10):9-12.
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微创手术入路与Judet入路治疗肩胛骨骨折的对比研究
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第24卷
期数:
2016年10期
页码:
9-12
栏目:
临床研究
出版日期:
2016-10-01

文章信息/Info

Title:
Comparative Study on the Scapular Fracture by Minimally Invasive Surgical Approach and Judet Approach
文章编号:
1005-0205(2016)10-0009-04
作者:
陈长青1△ 周影1 王耀生1 王成1 陈峥龙1 林灿斌1
1.厦门大学附属东南医院骨科医院,解放军第一七五医院 全军创伤骨科中心(福建 漳州,363000)
△.通信作者 E-mail:543593466@qq.com
Author(s):
CHEN Changqing1△ ZHOU Ying1 WANG Yaosheng1 WANG Cheng1 CHEN Zhenglong1 LIN Canbin1
1.Orthopaedic Hospital, Affiliated to Southeast Hospital of Xiamen University, the Orthopedic and Traumatologic Center of PLA in the 175th Hospital,Zhangzhou 363000,Fujian China.
关键词:
肩胛骨骨折;  微创入路;  Judet入路
Keywords:
scapular fractures;  minimally invasive surgical approach;  Judet approach
分类号:
R683.41
文献标志码:
A
摘要:
目的:探讨微创手术入路与传统Judet入路治疗肩胛骨骨折的临床疗效并进行分析。方法:选取2010年1月至2014年4月接受后路内固定手术治疗的52例肩胛骨骨折患者:男37例,女15例; 年龄20～48岁,平均(31.2±2.3)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23例采用微创手术入路行骨折切开复位内固定术(A组),29例采用传统Judet入路行骨折切开复位内固定术(B组)。通过比较2组患者手术切口总长度、手术时间、术中出血量、骨折愈合时间、Hardegger肩关节功能评分、并发症发生情况进行比较研究。结果:52例患者均获随访,随访时间18～24个月(平均22个月)。A组手术切口总长度、手术时间、术中出血量、骨折愈合时间均优于B组(P<0.05)。根据Hardegger肩关节功能评分标准:A组23例,优15例,良6例,可2例,差0例,优良率为91.30%; B组29例,优18例,良6例,可4例,差1例,优良率为82.76%.两组优良率比较,差异有统计学意义(P<0.05)。A组未出现并发症,B组发生肩胛上神经损伤1例,表现为肩关节活动乏力,经治疗后改善,并发症发生率为3.45%,B组并发症发生率高于A组,差异有统计学意义(P<0.05)。结论:与Judet入路相比,微创手术入路治疗肩胛骨骨折操作简便、并发症少,可作为肩胛骨骨折手术治疗的优先方案。
Abstract:
Objective:To compare the effect of minimally invasive surgical approach and Judet approach in the treatment of scapular fracture. Methods:Retrospective analyzed of 52 patients(male 37, female 15, ranging in age from 20 to 48 years, meanly(31.2±2.3)years)of scapular fractures which were treated by open reduction and internal fixation through the posterior approach from January 2010 to April 2014. 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 fracture in 7 cases. 23 patients in the A group were treated with operative treatment through minimally invasive surgical approach, and 29 patients in the B group were treated with surgical treatment through Judet approach. The incision length, the total operative time, intraoperative bleeding volume, the fracture healing time, Hardegger standard of clinical effects, and complications in two groups were compared. Results:All 52 patients were followed up for 22 months averagely(range 18 months to 24 months). The incisional length, the total operative time, intraoperative bleeding volume, the fracture healing time in A group were less than B group(P<0.05). According to Hardegger standard, there were excellent in 15 cases, good in 6 cases, average in 2 cases and poor in 0 case, with an excellent and good rate of 91.30% in the A group. There were excellent in 18 cases, good in 6 cases, average in 4 cases and poor in 1 case, with an excellent and good rate of 82.76% in the B group. The excellent rate of the A group was higher than the B group(P<0.05). There was no complication occurred in A group. There was one nerve damage case occurred in B group and the complication rate was 3.45%. The complication rate of B group was higher than the A group(P<0.05). Conclusion:Minimally invasive surgical approach in treatment of scapular fracture can be used as the preferred scheme for treating scapular fracture with advantages of easy operation, small trauma, definite effect, and little complication.

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更新日期/Last Update: 2016-10-15