The Choice Of The Treatment And The Clinical Curative Effect Contrast Analysis Of Scapula Fracture

Objective:Through the choice of the treatment and the clinical curative effect contrast analysis of scapula fracture, effectively and to explore the diagnosis and classification of scapula fracture specific treatment options, in order to achieve the best treatment of scapula fracture.Materials and Methods:Review our orthopaedic in from January 2004 to April 2014 treated48 patients with fracture of shoulder blade. Among them, male 33 cases, 15 cases of women. Based on Hardegger fracture classification to classify fractures: 14 cases of body fracture,8 cases of scapula neck fracture( anatomical neck fracture in 3 cases, 5 cases of surgical neck fracture),11 cases of scapula glenoid fractures(5 patients with jar fossa fracture, spoon edge fracture in 6 cases),3 cases of acromion fracture, coracoid process fracture 4cases, fracture of spina scapular 5 cases, 3 cases of comminuted fracture. Among them, 32 cases non-operative therapy, 16 cases treated with surgery.The non-operation treatment group 10 patients with operation indications but not treated with operation. The 48 patients were divided into three groups,the first group refer to the 22 cases of non operation does not have the operation indications,the second group is the non operation group with 10 cases of syndrome operation,the third group is the operation group. The stable no displacement or minimally displaced fracture we adopt non operation treatment,the shift is larger and unstable scapular fracture,10 cases(we have the operation indication)treated by non operation,16 cases treated with operation.Using Hardegger function assessment method to assess the effect of the treatment for different types of scapular fracture, found stable not displaced or minimally displaced scapular fractures through non operation treatment the excellent and good rate was higher. Shift greater and instability of scapular fracture,the excellent and good rate of the operation group was significantly higher than that of non operation group(10 cases with operation indication but not treated wiht operation).,at the same time the surgical complication rates lower than the second group of non operation(10 cases with operation indication but not treated wiht operation).Results:For those who did not follow-up with scores of cases, respectively, follow-up time between 12 ~ 48 weeks, the average of 26 weeks. All cases were healed, the healing time is about 6 ~ 12 weeks. According to Hardegger functional assessment:the 22 cases of the first group of non-surgical treatment : in 20 cases, good in 1 cases, medium in 1 cases and poor in 0 case. The 10 cases of second group of non-surgical treatment( with operation indication but not treated wiht operation):1 cases of excellent, good in 2 cases, medium in 2cases and poor in 5 cases,Surgery group included 16 cases: 12 cases of excellent, good in 2 cases, medium in 1 case and poor in 1 case. From the point of complications,the second group(with operation indication but not treated wiht operation)complication rate is significantly higher than that of the first group and the operation group.Conclusion:In clinical, scapular fractures of stable and have no displacement or shift slightly through non operation treatment can achieve satisfactory result, to the shift greater and unstable scapular fracture,the curative effect of the operation and non-operation have obvious difference.so normally the stable no shift or minimally displaced scapula fracture with conventional non-surgical treatment, but for the scapula fracture shift in severe cases, using surgical treatment can achieve better effect, and less complications. In clinical, can use the broken part,classification,shift to choice treatment.