【摘要】 [目的]为肩胛盂、肩胛颈处骨折的后路微创手术提供解剖学基础,并探讨临床疗效。[方法]8具成人尸体标本,观察在不切断三角肌、冈下肌及小圆肌情况下手术入路能显露的肩胛颈与肩胛盂范围。临床合并有肩胛盂、肩胛颈处骨折的肩胛骨骨折共21例,IdebergⅡ型13例,Ⅲ型4例,Ⅳ型3例,Ⅴ型1例,采用后路微创内固定术治疗。根据肩关节功能Constant评分、视觉模拟疼痛评分(VAS)综合判断疗效。[结果]微创后入路可以完整显露肩胛颈及大部分后方肩胛盂(显露范围68.67%~52.31%,平均60.34%)。21例临床病例均获随访,肩关节功能Constant评分末次优良率为95.3%~90.01%,平均91.82%;末次Constant肩关节评分较术前平均提高41.2分,VAS评分平均降低6.3分。[结论]后路微创手术治疗肩胛盂、肩胛颈处骨折,可获得满意疗效。更多还原

【Abstract】 [Objective]To investigate the anatomic basis of the posterior minimally invasive approach for intra-articular glenoid fracture and scapular neck fracture and apply it clinically in 21 cases to find the treatment effect. [Method]Eight adult cadavers were used to observe the expose range of scapular neck and glenoid cavity without cutting off the deltoid,infraspinatus,and teres minor. Then this approach was clinically applied in 21 cases. According to Ideberg classification,there were 13 cases of type II,and 4 cases of type III,3 cases of type IV,1 case of type V. All cases received minimally invasive posterior approach surgery. Constant scores of the shoulder function,visual analog scale( VAS) pain scores were used before and after operation to analyze the effects. [Result]Through the posterior minimally invasive approach,the whole scapular neck and most of the posterior glenoid can be revealed,with the exposure range of 68. 67%- 52. 31%( mean 60. 34%). All cases were followed up after surgery. The excellent and good results rate of Constant score was 95. 3% to 90. 01%( mean 91. 82%) at the last follow-up,which had been increased by 41. 2 points compared to the mean preoperative score. VAS score decreased by mean 6. 3 points compared to preoperation. [Conclusion]A satisfactory outcome could be obtained when intra-articular glenoid fracture and scapular neck fracture were treated through the posterior minimally invasive approach.更多还原