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首页> 外文OA文献 >Functional outcomes and clinical strength assessment after infraspinatus-sparing surgical approach to scapular fracture: Does it really make a difference?
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Functional outcomes and clinical strength assessment after infraspinatus-sparing surgical approach to scapular fracture: Does it really make a difference?

机译：腹下抗冲击性接种肩胛骨骨折后功能成果及临床强度评估：它真的有所作为吗？

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Abstract Background Surgical treatment of scapular fractures with posterior approach is frequently associated with postoperative infraspinatus hypotrophy and weakness. The aim of this retrospective study is to compare infraspinatus strength and functional outcomes in patients treated with the classic Judet versus modified Judet approach for scapular fracture. Patients and methods 20 cases with scapular neck and body fracture treated with posterior approach for lateral border plate fixation were reviewed. In 11 of 20 cases, we used the modified Judet approach (MJ group), and in 9 cases we used the classic Judet approach (CJ group). All fractures were classified according to the AO classification system. At follow-up examinations, patients had X-ray assessment with acromiohumeral distance (AHD) measurement, clinical evaluation, active range of motion (ROM) examination, Constant Shoulder Score, and Disability of the Arm, Shoulder and Hand (DASH) Score. Infraspinatus strength assessment was measured using a dynamometer during infraspinatus strength test (IST) and infraspinatus scapular retraction test (ISRT). Results Demographic data did not significantly differ between the CJ group and MJ group, except for mean follow-up, which was 4.15 years in the CJ group and 2.33 in the MJ group (p < 0.001). All X-ray examinations showed fracture healing. AHD was significantly decreased in the CJ group (p = 0.006). We did not find significant differences in active ROM between the MJ and CJ groups in the injured arm (p < 0.05). The Constant Score was 75.83 (±14.03) in the CJ group and 82.75 (±10.72) in the MJ group (p = 0.31); DASH Score was 10.16 in the CJ group and 6.25 in the MJ group (p = 0.49). IST showed mean strength of 8.38 kg (±1.75) in the MJ group and 4.61 kg (±1.98) in the CJ group (p = 0.002), ISRT test was 8.7 (±1.64) in the MJ group and 4.95 (±2.1) in the CJ group (p = 0.002). Infraspinatus hypotrophy was detected during inspection in six patients (five in the CJ group and one in the MJ group); it was related to infraspinatus strength weakness in IST and ISRT (p < 0.001). Conclusions Infraspinatus-sparing surgical approach for scapular fracture avoids infraspinatus hypotrophy and external-rotation strength weakness. We suggest use of the modified Judet approach for scapular fracture and to restrict the classic Judet approach to only when the surgeon believes that the fracture is not easily reducible with a narrower exposure. Level of evidence Level IV.
机译：摘要背景下肩胛骨骨折的外科治疗往往与术后腹下腹下垂和弱点有关。该回顾性研究的目的是比较用经典句子与修饰句子骨折治疗患者治疗的患者的Infraspinatus强度和功能结果。综述了患者和方法20例肩胛骨颈部和肩胛骨骨折治疗横向边缘板固定。在20例中，我们使用了修改后的Judet方法（MJ集团），在9例中，我们使用了经典的Judet方法（CJ集团）。所有骨折按AO分类系统分类。在后续检查中，患者用acromiohumeral距离（AHD）测量，临床评价，运动范围（ROM）检查，恒定肩部分数和臂，肩部和手（破折号）评分的X射线评估。使用逆烟灰质强度试验（IST）和INTAMAMINATUS肩带缩回试验（ISRT）测量IntraSpinatus强度评估。结果人口统计数据在CJ集团和MJ集团之间没有显着差异，除了平均随访，在CJ集团和2.33群中的415岁以下（P <0.001）。所有X射线检查显示骨折愈合。 CJ组AHD显着降低（P = 0.006）。我们在受伤臂中的MJ和CJ组之间没有发现有关的有源ROM（P <0.05）。 CJ组中的恒定得分为75.83（±14.03），在MJ组中为82.75（±10.72）（P = 0.31）; CJ集团的DASH得分为10.16，MJ组中的6.25（P = 0.49）。在MJ组中，IST在MJ组和4.61千克（±1.98）中显示为8.38千克（±1.75），在MJ组和4.95（±2.1）中，ISRT测试为8.7（±1.64）在CJ组（p = 0.002）。在六名患者的检查期间检测到血吸虫萎缩（CJ集团中的五个，在MJ集团中的一个）;它与IST和ISRT中的INTAMININATUS强度弱点有关（P <0.001）。结论腹下骨折的抗腹部骨折手术方法避免了抗腹下血吸虫和外旋强度的弱点。我们建议使用改良的句号方法进行肩胛骨骨折，并仅限于外科医生认为骨折不易降低较窄的暴露时，限制经典的句号方法。证据级别IV。

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