The Strategies In The Treatment Of Scapular Fracture

Objective:To investigate the early diagnosiS and the classification of scapular fracture.and the criterion of conserVatiVe and operative treatment,and to provide the proovfs to guide the diagnosiS and treatment in clinic practice.Methods:The study group consisted of eighty—six cases for scapular fracture received treatment in first,second and third hospital of jilin university.Views of X—ray and three——dimensional CT image reconstruction were used to conform their injures.According to the Hardegger'S classification for scapular fracture,all of them were Classified,and were treated with conservative and operative treatment by means of their fracture patterns,their conditions and associated injures.Conservative treatment for example the triangle cloth to fix up wound 1imbs were used for most cases.Operat ive treatment included reconstruct ion plate or together with lag screw for fixat ion of scapular fracture,and K—wire or reconstruction plate for clavicular and acromion fracture.Results:There were 53 cases fol lowed up in 75 cases with conservative treatment.The period of following up ranged from 5 months to 21 months,and averaged 9 months.A11 0f 1l cases with operative treatment were followed up.The period ranged from 4 months to 15 months,and averaged 7 months.A11 got bony heal ing.According to the ROWEevaluat ion,al1 cases were divided into 4 groups,excel lent cases,good cases,fair cases and poor cases.In 53 cases with conservative treatment,there were20 excellent cases(37.7%),16 good cases(30.2%),11 fair cases(20.8%) and 6 poor cases(11.3%).In 11 cases with operative treatment,there were 7 excel lent cases(63.6%),1 good cases(9 . 1 % ) , 2 fair cases(18 . 2 % )and 1 poor cases(9 . 1%). Complications appeared in 39 cases(73.6%) of the nonsurgical group and appeared in 5 cases(45.5%)of the surgi cal group.Conclusions:Scapular fractures are caused by high incidence of serious association injury:Three—dimensional CT recOnstructiOn may help US to make the diagnosis,to understand the frature patterns and the degree of displacement,and choose the fitting thrapy;Most cases of scapular fracture can be healed by conservt ive treatment,but there are more complications than some by operative treatment :Adolescent are the majority of a11 cases,the criterion of operat ive treatment need to be broadened for good therapeutic effects:Some cases especially the nonsurgical group cann't take exercise in time,and must strength exercise.