Clinical Efficacy In Non-operation And Operation Of Scapular Fractures

Objective: Through the analysis of clinical efficacy between non-operation andoperation treatment in scapular fracture to explore the scapular fracture treatmentoptions in order to guide clinical practices.Materials and Methods:74cases with scapular fracture that had been admitted toorthopedics in our hospital from January2006to December2010were retrospectivelyreviewed. Acorrding to Hardegger classification: the scapular body fracture in26cases, the glenoid rim fracture in15cases, the glenoid fossa fracture in5cases, thesurgical neck fracture in8cases, the anatomical neck fracture in1cases, the scapularspine fracture in6cases, the acromion fracture in3cases, the coracoid processfracture in2cases, the comminuted fracture in8cases. Off all74patients,47caseswere treated non-operation,27cases were trested operation. Hardegger functionevaluation system was adopted to rating the clinical efficacy of the two treatments.And the complications between two treatments were compared. We did the statisticsanalysis with2test by SPSS11.5sofeware. P<0.05has statistic significance.Results: All cases were followed up for4months to24months, an average of12months. Among47patients treated by non-operation, Hardegger function evaluationsystem showed that the result were excellent in17cases, good in20cases, fair in7and poor in3. Of27patients treated by operation, Hardegger function evaluationsystem showed that the result were excellent in17cases, good in6cases, fair in3andpoor in1. There was no significant difference in excellent and good rate of the twogroups (2=0.467，P=0.949). Complications appeared in30cases of the non-operation,22limited outreach,6traumatic joint disease,1joint instability,1heterotopicossification. Only10cases were appeared complications of the operation,7limited outreach,3traumatic joint disease. There was significant difference betweencomplications rate in the two groups（2=4.957，P=0.026）, non-operation are morecomplications than some by operation treatment.Conclusion: There was no significant difference in excellent and good rate of thenon-operation and operation treatment. They all have been good clinical efficacy.Fore the severely displaced scapular fracture, operation treatment can achieveexcellent reduction and fixation, but also reduce the complications compared withnon-operation. The scapular fracture treatment programe determined by the fracturelocation and displacement. It’s very important to strictly control the indications forsurgery.