Skapula kırıklarında cerrahi tedavi

Amaç: Cerrahi tedavi uygulanan skapula kırıklı olgulara ait bulgu ve sonuçları değerlendirmek. Çalışma planı: Skapula kırıklı altı hasta (4 kadın, 2 erkek; ort. yaş 40; dağılım 25-59) açık redüksiyon ve internal fiksasyonla tedavi edildi. Tüm yaralanmalar trafik kazası sonrası oluşmuştu ve hepsinde eşlik eden yaralanmalar vardı. Dört hastada skapula boyun kırığı, iki hastada glenoid çukuru kapsayan eklem içi kırık saptandı. Skapula kırıklı hastaların üçünde aynı tarafta klavikula kırığı da vardı. Hastalar ortalama 27 ay (dağılım 18-38 ay) süreyle izlendi. Hastaların son değerlendirmesi, Herscovici ve ark.nm fonksiyonel değerlendirme yöntemine göre yapıldı. Sonuçlar: Dört hastada mükemmel, bir hastada iyi, bir hastada orta sonuç alındı. Dört hastada hiç ağrı yoktu. Üç hasta yaralanma öncesindeki iş ve aktivitelerine geri döndü. Ev kadını olan iki hastanın iş yapabilme becerilerinde sorun yoktu. Dört hastada omuz abduksiyon veya fleksiyonu 120 derecenin üzerinde saptanırken, adale gücü "5" olarak belirlendi. Ameliyat sonrası komplikasyon oluşmadı. Çıkarımlar: Skapula boynu kırığı ile aynı tarafta klavikula kırığı veya glenoid çukurda önemli derecede ayrışmaya neden olan eklem içi kırıklarda, eklem sertliğini, fonksiyon kaybını, ağrıyı ve oluşabilecek sakatlık halini önleyebilmek için açık redüksiyon ve yeterli sıkı tespit ile erken rehabilitasyon uygulanabilir.

Anahtar Kelimeler:

Klavikula, Kırık tespiti, internal, Skapula, Çoklu travma, Omuz eklemi

Surgical treatment of scapular fractures

Objectives: To evaluate the findings and results in patients who were treated surgically for scapular fractures. Methods: Six patients (4 females, 2 males; mean age 40 years; range 25 to 59 years) with scapular fractures were treated by open reduction and internal fixation. All the frac-tures were caused by traffic accidents and all the patients had associated injuries. Four patients had scapular neck fractures, three of whom had accompanying ipsilateral clavicular fractures. In two patients, the fractures involved the glenoid fossa. The mean follow-up period was 27 months (range 18 to 38 months). Functional evaluations were made according to the scoring system described by Herscovici et al. Results: The results were excellent in six patients, good in one, and fair in one patient. Four patients had no pain. Three patients returned to preinjury jobs. Two patients who were housewives were able do their housework. The range of movement was greater than 120 degrees in both abduction and flexion, and the muscle strength was 5 in four patients. No postoperative complications were encountered. Conclusion: Open reduction and stabilization followed by early rehabilitation may be successful in preventing stiffness, pain, and disability in scapular neck fractures accompanied by ipsilateral clavicle fractures, or fractures involving the glenoid fossa and leading to significant dis-placement.

Keywords:

Clavicle, Fracture Fixation, Internal, Scapula, Multiple Trauma, Shoulder Joint,

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