肩甲骨体部骨折に対する手術治療経験 －上角及び下角骨折の2例－

概要

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We report 2 cases of osteosynthesis for scapular body fractures. One is a superior angle fracture, and another is a inferior angle fracture. Both are fractures with a separation of more than 10mm. In the first case a 42-year-old man injured his left shoulder in a fall during soccer game. Scapular Y roentgenography revealed superior angle fracture displaced approximately 12mm superiorly from the scapular spine. Operation was performed 10 days after injury. In the second case a 68-year-old man was injured in a bicycle accident. 3DCT imaging showed a large fragment containing inner border to be dislocated superiorly approximately 14mm from angulus inferior scapulae. Osteosynthesis was performed 9 days after the accident. In the first case the active ROM of the left shoulder was 160° in flexion, 40° in external rotation,and Th10 level in internal rotation at 3 months after surgery. In the second case the active shoulder ROM was 140° in flexion, 50° in external rotation,and Th12 level in internal rotation at 3months after surgery. Nordqvist et al reported that 57% of the patients with residual scapulae displacement (> 10mm) had shoulder symptoms after conservative treatment of the scapular body fractures. Although there are different opinions, we chose surgical treatment to avoid malunion.