当院における肩甲骨骨折手術症例の検討

抄録

We performed surgical treatments on 6 (4 males and 2 females) cases of scapula fractures with considerable displacement and instability out of 19 cases of the patients diagnosed in our hospital between Apr. 2007 and May. 2009. The mean age was 46.7 (30-59) years old and the follow-up period was 16.0 (7-26) months. The causes of trauma were falls and traffic accidents. The sites of scapula fractures were glenoid fossa, neck, body, coracoid process, acromion, and their combinations. The associated injuries were clavicle fracture, head or chest injury, anterior fracture-dislocation of the proximal humerus, and massive rotator cuff tear. At the final examinations, 5 cases had no pain and 1 had slight pain on heavy labor. Only 1 case had residual limited range of motion of the shoulder joint, but it did not make difficulties in his activities of daily life and work. All the cases got bone union without residual muscle weakness and returned to their previous work during the follow-up period. Although the indication for surgical treatments on scapula fractures is still controversial, Goss suggestively recommended surgeries for the cases with unacceptable instability and displacement due to double disruptions of superior shoulder suspensory complex, including floating shoulders. Four cases of the present 6 cases met this theory and the other 2 cases had severe associated injuries in addition to displaced scapula fractures, a fracture-dislocation of the proximal humerus and a massive rotator cuff tear, respectively. As we obtained good postoperative results from the present 6 cases, we conclude that a surgical treatment should be considered on scapula fractures with considerable displacement and instability such as a floating shoulder.