目的:确定肩胛骨骨折切开复位内固定术后的短期并发症发生率,影响不良事件发展的因素,和基于骨折解剖位置的并发症发生率。
方法:比较肩胛骨切开复位内固定术患者30天并发症发生率,身体,喙突,和肩峰骨折位置,由国际疾病分类代码确定。可能的不良事件包括术后手术部位感染,肾功能不全,插管,肺炎,深静脉血栓形成,肺栓塞,尿路感染,伤口裂开,中风,和输血。
结果:共发现251例肩胛骨骨折,161个已知骨折位置:105个关节盂,20具尸体,9喙突,和27个肩峰骨折.所有肩胛骨骨折的不良事件发生率为2.0%,解剖位置之间没有显着差异(p=0.79)。总体输血率,手术部位感染,返回OR为0.4%,0.8%,3.98%。使用类固醇与任何不良事件的风险显着增加相关(OR:55.57,p=0.038),门诊状态显示出对再次手术的保护作用(OR:0.11,p=0.014)。两组之间的比率没有显着差异[输血(p=0.91);手术部位感染(p=0.17);再次手术(p=0.85)]。
结论:ORIF治疗肩胛骨骨折30天内并发症发生率较低。再手术是最常见的并发症,其次是手术部位感染,伤口裂开,中风,输血,和肺炎。使用类固醇是发生任何不良事件的风险因素,门诊状态对再次手术有保护作用。关节盂的30天并发症概况,身体,喙突,和肩峰骨折没有显着差异。低并发症发生率支持内固定手术干预的相对短期安全性。
方法:三级。
OBJECTIVE: To determine the short-term complication rates following open reduction and internal fixation of scapula fractures, factors affecting the development of adverse events, and complication rates based on the anatomic location of the fracture.
METHODS: Thirty-day complication rates for patients who underwent open reduction and internal fixation of the scapula were compared between glenoid, body, coracoid, and acromion fracture locations, as identified by International Classification of Disease codes. Possible adverse events included postoperative surgical site infection, renal insufficiency, intubation, pneumonia, deep vein thrombosis, pulmonary embolism, urinary tract infection, wound dehiscence, stroke, and blood transfusion.
RESULTS: A total of 251 scapula fractures were identified, with 161 having known fracture locations: 105 glenoid, 20 body, 9 coracoid, and 27 acromial fractures. The rate of any adverse event for all scapular fractures was 2.0%, with no significant difference between anatomic locations (p = 0.79). The overall rates of transfusion, surgical site infection, and return to OR were 0.4%, 0.8%, and 3.98%. Steroid use associated with a significantly increased risk of any adverse event (OR: 55.57, p = 0.038) and outpatient status demonstrated a protective effect on reoperation (OR: 0.11, p = 0.014). There were no significant differences in the rates between groups [transfusion (p = 0.91); surgical site infection (p = 0.17); reoperation (p = 0.85)].
CONCLUSIONS: Complication rates within thirty days of ORIF for scapula fracture were low. Reoperation was the most common complication, followed by surgical site infection, wound dehiscence, stroke, transfusion, and pneumonia. Steroid use was a risk factor for developing any adverse event, and outpatient status was protective against reoperation. The 30-day complication profile of glenoid, body, coracoid, and acromial fractures was not significantly different. The low complication rates support the relative short-term safety of operative intervention with internal fixation.
METHODS: Level III.