背景:探讨腋路手术治疗IdebergⅠ、Ⅱ型肩胛骨关节盂骨折的临床疗效。
方法:回顾性分析济宁医学院附属医院收治的13例肩胛骨盂骨折,嘉祥县人民医院,邹城市人民医院,雁州区人民医院,2020年12月至2022年1月,和畜城县人民医院。8名男性(包括1名双边)和5名女性,平均年龄为57.5岁(33至75岁)。根据Ideberg分类,有10例Ⅰa型,1例Ⅰa型与Ⅰb型相结合,2例II型。所有患者均采用腋路手术治疗,7例合并肩关节前脱位患者采用一期手法和二期再手术治疗。七名病人用钢丝锚固定,3例Ⅰa型患者用“T”板固定,5例患者并发肩袖撕裂,并用钢丝锚钉修复。在最后一次随访中,Constant-Murley肩关节功能评分,视觉模拟分数,DASH得分,Hawkins评分用于评估肩关节功能,疼痛,治疗后的稳定性。
方法:干预措施是使用腋路治疗IdebergI型和II型舟骨骨折患者。
结果:本组13例患者均获得全面随访,随访时间为12到25个月,平均18.6个月。手术时间为65至135分钟,平均85.6分钟。术中失血20~120mL,平均55.6mL。住院时间7~22天,平均9.6天。所有患者手术切口均为A级愈合。术后3个月观察关节盂骨折骨愈合情况。
结论:对于IdebergI型和II型肩胛骨关节盂骨折,腋下入路是一种可行的手术入路,可以通过肌肉间隙完全进入,手术创伤最小,术后轻度疼痛,临床效果满意。
BACKGROUND: To investigate the clinical efficacy of the axillary approach in the surgical treatment of Ideberg type I and II scapular glenoid fractures.
METHODS: Retrospective analysis of 13 cases of scapular glenoid fracture treated in the affiliated Hospital of Jining Medical College, Jiaxiang County People hospital, Zoucheng City people Hospital, Yanzhou District People Hospital, and Juancheng County people Hospital from December 2020 to January 2022. Eight males (including 1 bilateral) and 5 females, with an average age of 57.5 years (range from 33 to 75 years). According to Ideberg classification, there were 10 cases of type I a, 1
case of type I a combined with type I b, and 2 cases of type II. All patients were treated with axillary approach surgery and 7 patients with combined anterior shoulder dislocation were treated by first-stage manipulation and second-stage reoperation. Seven patients were fixed with a wire anchor, 3 patients with type I a were fixed with a \"T\" plate, and 5 patients were complicated with rotator cuff tear and were repaired with a wire anchor. At the last follow-up, the Constant-Murley shoulder function score, visual analog score, DASH score, and Hawkins grade were used to evaluate shoulder function, pain, and stability after treatment.
METHODS: The intervention was to treat patients with Ideberg type I and II scaphoid fractures using an axillary approach.
RESULTS: All 13 patients in this group were followed up thoroughly, and the follow-up time was 12 to 25 months, with an average of 18.6 months. The operation time was 65 to 135 minutes, with an average of 85.6 minutes. Intraoperative blood loss ranged from 20 to 120 mL, averaging 55.6 mL. The duration of hospitalization ranged from 7 to 22 days, with an average of 9.6 days. The surgical incisions of all patients were grade-A healing. Bone healing of glenoid fractures was observed 3 months after the operation.
CONCLUSIONS: The axillary approach for Ideberg type I and II scapular glenoid fractures is a feasible surgical approach with complete access through the muscle gap, minimal surgical trauma, mild postoperative pain, and satisfactory clinical results.