背景:由于肩胛骨的不规则形状和不同类型的骨折,在临床实践中缺乏标准的内固定装置,即使有很多选择。本研究旨在比较钛解剖钢板和重建钢板治疗肩胛骨关节外骨折的疗效(MillerIIb型,IIc,andIV).
方法:对2017年3月至2020年3月期间接受肩胛骨关节外骨折治疗的41例患者进行回顾性研究。根据固定装置将患者分为2组:钛解剖钢板组(20例)和钛重建钢板组(21例)。随访12-18个月后,一般特征,围手术期特点,术后随访结果,比较2组的影像学资料。
结果:两组的手术都顺利。解剖板组在手术时间和术中出血量方面明显优于重建板组(P<0.001)。术后3个月随访,Constant-Murley得分(P=.026),肩关节屈曲运动范围,解剖钢板组及肩关节外展活动度均明显优于重建钢板组(P<.001)。2组术后西安大略肩关节不稳评分相似。影像学显示两组患者的功能恢复和稳定可靠的固定。两组骨愈合时间相似(解剖板组9.10±1.25周,重建板组9.24±1.41周)。P=.742)。所有患者均未发生并发症,如固定失败,不稳定性,或者骨不连。
结论:外科医生应积极考虑钛解剖钢板治疗肩胛骨关节外骨折,因为它们具有明显的疗效,手术时间短。术中失血少,更好的固定,和快速的短期功能恢复。
BACKGROUND: Because of the irregular shape of the scapula and the different types of fractures, a standard internal fixation device is lacking in clinical practice, even though there are many options available. This study aimed to compare the therapeutic efficacy of titanium anatomic and reconstructive plates for extra-articular fractures of the scapula (Miller types IIb, IIc, and IV).
METHODS: A retrospective study of 41 patients who underwent treatment for extra-articular fractures of the scapula between March 2017 and March 2020 was conducted. Patients were divided into 2 groups based on the fixation device: titanium anatomic plate group (20 patients) and titanium reconstructive plate group (21 patients). After follow-up for 12-18 months, the general characteristics, perioperative characteristics, postoperative follow-up findings, and imaging data of the 2 groups were compared.
RESULTS: The surgical procedures were uneventful in both groups. The anatomic plate group significantly outperformed the reconstructive plate group with respect to surgical duration and intraoperative blood loss (P < .001). At 3-month postoperative follow-up, the Constant-Murley score (P = .026), shoulder flexion range of motion, and shoulder abduction range of motion in the anatomic plate group were all significantly better than those in the reconstructive plate group (P < .001). The postoperative Western Ontario Shoulder Instability scores of the 2 groups were similar. Imaging showed functional recovery and stable and reliable fixation in both groups. Time to bone union was similar in both groups (9.10 ± 1.25 weeks in anatomic plate group and 9.24 ± 1.41 weeks in reconstructive plate group, P = .742). No complications occurred in any patient, such as fixation failure, instability, or bone nonunion.
CONCLUSIONS: Surgeons should favorably consider titanium anatomic plates for the treatment of extra-articular scapular fractures owing to their clear efficacy associated with a shorter surgical time, less intraoperative blood loss, better fixation, and rapid short-term functional recovery.