| 肩前方入路治疗Ideberg Ⅰa型肩胛盂骨折的疗效分析 |
| Clinical analysis of the efficacy of the anterior shoulder approach in the treatment of Ideberg type Ⅰa glenoid fractures |
| 投稿时间：2025-09-09 |
| DOI：10.3969/j.issn.1672-5972.2026.04.006 |
| 中文关键词: 肩前方入路 肩胛盂骨折 Ideberg Ⅰa型 |
| 英文关键词:Anterior shoulder approach Glenoid fracture Ideberg type Ⅰa |
| 基金项目: |
| 作者 | 单位 | 邮编 | | 雷诚* | 1武汉科技大学医学院,湖北 武汉,430065 | 430065 | | 职晓松 | 2中国人民解放军中部战区总医院骨科,湖北 武汉,430070 | 430070 | | 姜壮 | 2中国人民解放军中部战区总医院骨科,湖北 武汉,430070 | 430070 | | 项阳 | 2中国人民解放军中部战区总医院骨科,湖北 武汉,430070 | 430070 | | 王华松* | 2中国人民解放军中部战区总医院骨科,湖北 武汉,430070 | 430070 |
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| 中文摘要: |
| 目的 探究采用肩前方入路治疗Ideberg Ⅰa型肩胛盂骨折的疗效。方法 回顾性分析2019年1月至2024年3月中国人民解放军中部战区总医院采用肩前方入路治疗的28例肩胛盂骨折患者的临床资料。其中，16例采用预塑形微型钢板内固定治疗，12例采用可吸收螺钉内固定治疗。记录手术时间、术中出血量、住院天数，末次随访时的肩关节功能Constant-Murley评分（CSS）、ASES评分，以及肩关节前屈、外展、外旋、内旋活动度来评定疗效。结果 28例患者均获得随访，随访时间为12～18个月（平均15个月），患者均骨性愈合。手术时间平均103 min，术中出血量平均61.5 mL，住院天数平均9.2 d。末次随访时Constant-Murley评分75～92分，平均（83.8±4.2）分；ASES评分57～97分，平均（84.3±11.6）分；肩关节前屈150°～170°，平均（164.2±12.8）°；肩关节外展120°～175°，平均（150.8±21.5）°；肩关节外旋60°～78°，平均（68.1±11.2）°，肩关节内旋T5-T7棘突（平均T6棘突）。患者的Constant-Murley评分、AESE评分及肩关节活动度较术前均有明显改善（P＜0.05），术后1例出现创伤性关节炎，其余未见明显并发症。结论 采用肩前方入路治疗Ideberg Ⅰa型肩胛盂骨折具有固定稳定、术野暴露好，术后并发症少且能尽早恢复功能等优点，为临床上治疗此类骨折提供参考。 |
| 英文摘要: |
| Objective To evaluate the efficacy of the anterior shoulder approach in the treatment of Ideberg type Ⅰa glenoid fractures.Methods A retrospective analysis was conducted on the clinical data of 28 patients with glenoid fractures who were treated via the anterior shoulder approach between January 2019 and March 2024 at Central Theatre General Hospital of PLA. Among them, 16 patients underwent internal fixation with precontoured miniplates, and 12 patients were treated with absorbable screws. Operative time, intraoperative blood loss, length of stay, and shoulder function－assessed using Constant-Murley Score (CSS), American Shoulder and Elbow Surgeons (ASES) Score, as well as range of motion (forward flexion, abduction, external rotation, and internal rotation), were recorded and analyzed at 3 months postoperatively and at the final follow-up.Results All 28 patients were followed up for a period ranging from 12 to 18 months, with a mean duration of 15 months. Bony union was achieved in all cases. The mean operative time was 103 min, with an average intraoperative blood loss of 61.5 mL and a mean hospital stay of 9.2 d. At the final follow-up, the Constant-Murley score ranged from 75 to 92 points [mean (83.8±4.2) points], and the ASES score ranged from 57 to 97 points [mean (84.3±11.6) points]. Shoulder forward flexion ranged from 150° to 170° [mean (164.2±12.8)°], abduction from 120° to 175° [mean (150.8±21.5)°], and external rotation from 60° to 78° [mean (68.1±11.2)°]. Internal rotation reached between the T5 and T7 spinal processes (mean, T6). Significant improvements were observed in the Constant-Murley score, ASES score, and shoulder range of motion compared with preoperative values. One patient developed traumatic arthritis postoperatively, with no other notable complications reported.Conclusion The anterior shoulder approach for the treatment of Ideberg Ⅰa glenoid fractures offers the advantages of stable fixation, the use of low-profile implants, a low postoperative complication rate, and facilitation of early functional recovery, thereby providing a valuable reference for the clinical management of such fractures. |
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