Biomechanics of internal fixation for treating floating shoulder injury
DUAN Lian-Hong, HUANG Ji-Feng, ZHAO Wei-Dong, LIANG Dong-Zhu, XIA Ping-Guang, LIU Xin-Yuan
Chinese Journal of Clinical Anatomy ›› 2011, Vol. 29 ›› Issue (3) : 339-342.
Biomechanics of internal fixation for treating floating shoulder injury
Objective To evaluate biomechanic effects of commonly used internal fixation methods on the treatment of floating shoulder injury. Methods The superior suspensory shoulder complex (SSSC) were dissected for simulating floating shoulder injury in 7 antiseptic upper limb specimens including collarbone and scapula. The testing included the normal specimens, simple clavicle fixation, single plate fixation of clavicle and scapula neck, and double plate fixation of clavicle and scapula neck. The ROMs of scapula neck under different states were measured by spinal motion analysis system, as well, the stability of different fixation methods for instable SSSC was compared. Results The biomechanical testing showed that, the ROMs of simple clavicle fixation were respectively (12.60±1.86)° for flexion,(8.53±1.17)° for extension,(12.47±1.43)° for left bending,(12.32±1.35)° for right bending,(10.17±1.16)° for left tortion, and (11.42±1.21)° for right tortion, which increased more obviously compared to that of other groups (P<0.05). ROMs of double plate fixation were respectively (5.53±1.12)° for flexion, (2.63±1.06)° for extension, (3.17±0.82)° for left bending, (7.03±0.60)° for right bending,(3.88±0.64)° for left tortion, and (5.33±1.54)° for right tortion, which decreased more significantly compared to that of other fixation methods (P<0.05). Conclusions Double plate fixation of clavicle and scapula neck is the best way to treat floating shoulder injury, which is helpful for avoiding scapula malunion and the instability of the shoulder.
Floating shoulder injury / Superior suspensory shoulder complex(SSSC) / / Internal fixation / Biomechanics
[1] Herscovici D，Fiennes AG，Allgower M，et al． The floating shoulder：ipsilateral clavicle and scapular neck fracture
[J].J Bone Joint Surg (Br)，1992，74(3)：362-364．
[2] 张英泽, 冯和林, 李增炎, 等. 浮肩损伤的外科治疗(附31 例报告)
[J]. 中国医师进修杂志, 2006, 29 (8) : 33-37.
[3] 贾健, 裴福兴, 郭录增, 等. 浮肩损伤
[J]. 中华骨科杂志, 2006, 26 (5) : 294-299.
[4] 朱清安，原林，钟世镇，等. 中、下部颈椎的三维运动［J］.中国临床解剖学杂志，1992，10(4)：300-302.
[5] Hashiguchi H, Ito H. Clinical outcome of the treatment of floating shoulder by osteosynthesis for clavicular fracture alone
[J]. J Shoulder and Elbow Surgery, 2003, 12 ( 6 ) : 589-591.
[6] Low CK, Lam AW. Results of fixation of clavicle alone in managing floating shoulder
[J] . Singapore Med , 2000 ,41( 9) :452 - 453.
[7] Ganz R, Noesberger B. Treatment of scapular fratures
[J]. Hefte Unfallheilkd, 1975, 126(1): 59 - 62.
[8] Egol KA, Connor PM, Karunakar MA, et al. The floating shoulder: clinical and functional results
[J]. J Bone Joint Surg Am , 2001, 83(8): 1188-1194.
[9] Leung KS, Lam TP. Open reduction and internal fixation of ipsilateral fractures of the scapular neck and clavicle
[J]. J Bone Joint Surg Am, 1993, 75(7): 1015 - 1018.
[10] 卢小虎,肖德明,林博文. 肩胛骨骨折合并锁骨骨折治疗方法探讨
[J]. 中华创伤杂志, 2005, 21(4): 264 - 266.
[11] 黄哲元，陈长青，郭林新, 等．浮肩损伤的治疗方法选择
[J]．临床骨科杂志，2006，9 ( 6 )：528-530.
[12] 郝 毅，杨文勋，赵大正.预弯双钢板治疗肩胛颈骨折的影像学研究与临床应用［J］.中华创伤杂志，2000, 16(3)：173-175.
[13] 李文基.梁小军.程德根．移位肩胛颈骨折的手术方法研究
[J]．中华医学杂志, 2006, 86（23）：1615-1619.
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