摘要
目的总结肩胛盂Ideberg Ia型骨折合并肩袖损伤的特点和诊疗策略。方法回顾性分析2021年1月至2024年4月广东省中医院和南雄市中医院收治的5例肩胛盂IdebergⅠa型骨折合并肩袖损伤患者资料,均为女性,年龄60~86岁,平均(71.40±9.02)岁。均为新鲜外伤,4例受伤时存在肩关节脱位。3例为单纯肩胛盂IdebergⅠa型骨折合并肩袖损伤,1例合并胫骨近端骨折,1例合并肩关节肱骨大结节撕脱骨折。2例首诊漏诊肩袖损伤。均采用肩关节镜下探查+肩胛盂骨折复位锚钉固定术+肩袖修补术治疗。结果术后随访9~37个月,平均(19.60±9.62)个月。随访期间均未出现肩关节脱位。术后2例肩关节无疼痛、肩关节活动恢复正常;1例肩关节无疼痛,肩关节活动轻度受限,但可满足日常生活的活动要求;2例肩关节偶有疼痛、肩关节活动轻度受限,但可满足日常生活的活动要求。结论肩胛盂IdebergⅠa型骨折合并肩袖损伤好发于老年人;伴随的肩袖损伤、神经损伤、骨质疏松症可能被忽略;建议同期手术处理合并的肩袖断裂或肱骨大结节骨折,肩胛盂骨折块下方与肩胛盂间的盂唇连续性有利于骨折块复位和固定,骨折块复位、固定困难时可采用双排固定技术或Double-pulley双排锚钉技术。
Objective To summarize the characteristics,diagnosis and treatment strategies of Ideberg typeⅠa fractures of the scapular pelvis combined with rotator cuff injuries.Methods A retrospective analysis was conducted on the data of 5 patients with scapular pelvis Ideberg typeⅠa fractures combined with rotator cuff injuries admitted to Guangdong Hospital of Traditional Chinese Medicine and Nanxiong Hospital of Traditional Chinese Medicine from January 2021 to April 2024.All patients were female,aged 60 to 86 years,with an average age of(71.40±9.02)years.All were fresh traumas.Four cases had dislocation of the shoulder joint at the time of injury.Three cases were simple Ideberg typeⅠa fractures of the scapular pelvis combined with rotator cuff injury.One case was combined with a proximal tibial fracture.One case was combined with an avulsion fracture of the greater tubercle of the humerus of the shoulder joint.Two cases of rotator cuff injury were initially missed at diagnosis.All were treated with arthroscopic exploration of the shoulder,reduction,and anchor fixation of glenoid fractures,and rotator cuff repair.Results The postoperative follow-up period ranged from 9 to 37 months,with an average of(19.60±9.62)months.No shoulder dislocation occurred during the follow-up period.After the operation,two cases had no pain in the shoulder joint,and the shoulder joint movement returned to normal.One case had no pain in the shoulder joint,and the movement of the shoulder joint was slightly limited,but it could meet the activity requirements of daily life.Two cases had occasional pain in the shoulder joint and mild limitation of shoulder joint movement,but could meet the activity requirements of daily life.Conclusion Ideberg typeⅠa fractures of the scapular pelvis combined with rotator cuff injuries are more common in the elderly.The accompanying rotator cuff injuries,nerve injuries,and osteoporosis may be overlooked.It is recommended that concurrent surgical treatment be carried out for combined rotator cuff fractures or greater tuberosity fractures of the humerus.The continuity between the lower part of the glenoid fracture and the labrum between the glenoid is conducive to the reduction and fixation of the fracture.When the reduction and fixation of the fracture are difficult,the double-row fixation technique or the Double pulley double-row anchor technique can be adopted.
作者
潘建科
李锋
罗明辉
杨均政
陈海云
赵金龙
杨伟毅
Pan Jianke;Li Feng;Luo Minghui;Yang Junzheng;Chen Haiyun*;Zhao Jinlong;Yang Weiyi(Department of Sports Medicine,Guangdong Hospital of Traditional Chinese Medicine,Guangzhou 510120,China;The Second Department of Orthopaedics,Chinese Medicine Hospital of Nanxiong,Nanxiong 512400,China)
出处
《实用骨科杂志》
2025年第8期678-683,共6页
Journal of Practical Orthopaedics
基金
国家自然科学基金资助项目(82474528)
广州市科技计划项目(2023A03J0238)
广东省中医院第十三届朝阳人才(临床型)立项课题(ZY2022YL21)。
