肩胛骨骨折ppt課件(編輯修改稿)
2025-04-18 08:29 本頁面
【文章內(nèi)容簡(jiǎn)介】 ts can often be treated nonoperatively unless high physical demand patient Fractures at base coracoid generally minimally displaced and treated nonoperatively. Fibrous union may occur but rarely source disfort 合并有臂叢或肩胛上神經(jīng)損傷時(shí) 合并肩鎖關(guān)節(jié) Ⅲ 度脫位時(shí) Isolated Fractures of the Acromial Process Scapula series detects most acromial fractures Most are nondisplaced or minimally displaced and treated symptomatically Fixation of Acromial Fractures If ORIF undertaken tension band construct for fractures at distal portion and recon plate for more proximal fractures Double Disruptions of the Superior Suspensory Shoulder Complex (SSSC) SSSC is a bonesoft tissue ring at the end of a superior and inferior bone strut Ring includes glenoid process, coracoid process, CC ligaments, distal clavicle, AC joint, acromial process Superior strut is middle third clavicle Inferior strut is lateral scapular body and spine Superior Shoulder Suspensory Complex Double Disruption of SSSC Traumatic disruption 2 or more ponents SSSC usually secondary to high energy injury and frequently require surgical management Frequently described as ―Floating Shoulder‖ Potential long term consequences nonoperative treatment include: nonunion, malunion, impingement, altered shoulder mechanics, DJD, neurovascular promise Floating Shoulder Operative management remended because of potential instability, displacement of glenoid Recent series of floating shoulders treated nonoperatively shows good results with conservative care. Nonoperative Management of Ipsilateral Fractures of the Scapula and Clavicle Retrospective review of 20 cases –11 of 20 clavicle fx’s displaced 10 mm –5 of 20 scapular fx’s displaced 5 mm Treated with sling or immobilizer Evaluated by 3 different shoulder scores, strength pared to uninjured shoulder. Edwards SG, et al. JBJS 82B: 77480, 2022 Results 1 clavicle nonunion (segmental bone loss at injury) Strength = to opposite arm in all Constant score 96, Rowe score 95 1718 patients excellent results depending on evaluation system Edwards SG, et al. JBJS 82B: 77480, 2022 Summary Floating Shoulder Nonoperative treatment sufficient for many of these injuries. Each ponent of the injury should be separately evaluated for indications for surgery, but the bination itself does not mandate operative intervention Scapulothoracic Dissociation Traumatic disruption of scapula from posterior chest wall Neurovascular injury mon Scapulothoracic Dissociation = Closed Forequarter Amputation Scapulothoracic Dissociation Left scapulothoracic dissociation with brachial artery disruption Scapulothoracic Dissociation Ra
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