Objective To explore the effective method for treatmentof fracturesof scapular neck.Methods A retrospective analysis of 30 patients with fractures of scapular neck was done. The patients were treated by operation or by nonoperation from May 1994 to May 2003. According to the degree of displacement,30 cases included 9 mild displaced fractures( lt;10 mm) and 21 severe displaced fractures( gt;10 mm). According to the location of fractures, there were 24 cases of surgical neck fractures and 6 cases of anatomical neck fractures. Of all 30 patients, 12 were treated by nonoperation and 18 by operation. All fractured scapularnecks were exposed through posterior approach and fixed with interfragmentary compression screws, reconstruction plates and so on after satisfactory reduction.Associated clavical fractures were exposed through Langer’s approach and fixed with Kirschner wire-tension band fixation construct, reconstruction plates and so forth. When followed up, the clinical examination was done and the X-ray filmswere taken to measure glenopolar angle(GPA). Herscovici’s score was adopted.Results Twenty-eight patients were followed up from 14 days to 9 years. Among 11 patients treated by non-operation, Herscivici score showed that 4 cases achieved the excellent result, 2 cases good, 2 cases fair and 3 cases poor and the X-ray film results showed that there were 6 cases of GPA>20° and 5 cases of GPA<20°. Of 17 patients treatedby operation, Herscivici score showed that 11 cases achieved the excellent result, 5 cases good and 1 case fair and the X-ray film results showed that there 16 cases of GPA>20° and 1 case of GPA<20°.Conclusion Fractures of scapular surgical neck with mild displacement can be treated by nonoperation, while fractures of surgical neck with severe displacement or associated with ipsilateral clavical fractures, and fractures of anatomical neck should be treated by operation to reconstruct the stabilityof shoulder and minimize the complications.
Citation: DING Xianjun,FAN Shunwu,ZHANG Jian.. A COMPATIVE STUDY ON OPERATION AND NON-OPERATION IN TREATING FRACTURES OF SCAPULAR NECK. Chinese Journal of Reparative and Reconstructive Surgery, 2005, 19(6): 446-449. doi: Copy