Clinical Efficacy In Non-operation And Operation Of Scapular Fractures

Objective: Through the analysis of clinical efficacy between non- operation and operation treatment in scapular fracture to explore the scapular fracture treatment options in order to guide clinical practices. Materials and Methods: 57 cases with scapular fracture that had been admitted to orthopedics in our hospital from January 2010 to December 2014 were retrospectively reviewed. Acorrding to Hardegger classification: the scapular body fracture in 20 cases, the glenoid rim fracture in 12 cases, the glenoid fossa fracture in 4 cases, the surgical neck fracture in 6 cases, the anatomical neck fracture in 1cases, the scapular spine fracture in 4 cases, the acromion fracture in 2 cases, the coracoid process fracture in 2 cases, the comminuted fracture in 6 cases. Off all 57 patients, 39 cases were treated non-operation, 18 cases were trested operation. Hardegger function evaluation system was adopted to rating the clinical efficacy of the two treatments.And the complications between two treatments were compared. We did the statistics analysis with2? test by SPSS 17.0 sofeware. P <0.05 has statistic significance.Results: All cases were followed up for 3 months to 24 months, an average of 12 months. Among 39 patients treated by non- operation, Hardegger function evaluation system showed that the result were excellent in 14 cases, good in 17 cases, fair in 6 and poor in 2. Of 18 patients treated by operation, Hardegger function evaluation system showed that the result were excellent in 12 cases, good in 3 cases, fair in 2 and poor in 1. There was no significant difference in excellent and good rate of the two groups(2? =0.117, P =0.732). Complications appeared in 25 cases of the non-operation, 17 limited outreach, 4 traumatic joint disease, 2 joint instability, 2 heterotopic ossification. Only 6 cases were appeared complications of the operation, 4 limited outreach, 1 traumatic joint disease, 1 heterotopic ossification. There was significant difference between complications rate in the two groups(2? =4.700, P=0.030), non-operation are more complications than some by operation treatment.Conclusion: There was no significant difference in excellent and good rate ofthe non- operation and operation treatment. They all have been good clinical efficicy. Fore the severely displaced scapular fracture, operation treatment can achieve excellent reduction and fixation, but also reduce the complications compared with non-operation.The scapular fracture treatment program determined by the fracture location and displacement. It’s very important to strictly control the indications for surgery.