Background This study aimed to compare the functional outcomes of the Y-type locking plate with the straight reconstruction locking plate for severe displaced scapular fractures. Methods This was a retrospective cohort study of 37 patients with severe displaced scapular body and neck fractures treated between July 2013 and October 2016 at the Hanzhong Central Hospital. Treatment selection was based on the surgeon’s experience and discussion with the patient. Sixteen patients received Y-type locking plates and 21 patients received straight reconstruction locking plates. The primary indexes were the Constant Shoulder Function (CSF) and Disabilities of the arm, shoulder, and hand (DASH) scores at 3, 6, and 12 months. Results There were 32 males and five females. Mean age was 46.0 ± 10.0 years. The cause of injury included car accident, fall, high fall, and bruising. At 3 months, compared with the straight reconstruction locking plate group, the Y-type locking plate group showed higher CSF scores (82.9 ± 3.5 vs. 79.3 ± 4.4, P = 0.01) and lower DASH scores (9.5 ± 2.5 vs. 12.7 ± 3.9, P = 0.008). There were no differences at 6 and 12 months. There were no differences between the two groups regarding intraoperative blood loss ( P = 0.65) and operation time ( P = 0.634). There were no complications such as plate rupture and screw prolapse during the 1-year follow-up. Conclusions Open reduction using the distal humeral Y-type locking plate can achieve better short-term functional outcomes (3 months) than the straight reconstruction locking plate for severe displaced scapular body and neck fractures, but outcomes are similar at 6 and 12 months. Level of evidence: II-2.
ObjectiveFor complex and unstable scapular fractures requiring simultaneous fixation of the glenoid neck, the lateral margin of the body, and/or the scapular diaphysis, reconstruction locking plate is difficult to achieve satisfactory fixation. In order to optimize the fixation effect, the newly designed claw‐shaped bone plate was designed for fixing such fractures. We also evaluate the clinical effects and follow‐up at an average of 1 year after treatment in scapular internal fixation by using reconstruction locking plate and claw‐shaped bone plate in complex unstable scapular body and glenoid neck fracture.MethodsA retrospective study was conducted from 2018 to 2021, thirty‐three patients (27 males and six females) who were defined unstable scapular fractures by Ada–Miller. Fifteen patients (52.86 ± 8.26 years) received claw‐shaped bone plate and 18 cases (51.61 ± 11.31 years) received reconstruction locking plate with the intermuscular approach. The clinical effect was evaluated based on the operation time, intraoperative blood loss, surgical complications, clinical healing time and Constant–Murley score (CMS). The data analysis by Student t, Mann–Whitney U test and Pearson's chi squared test.ResultsCompared with reconstruction locking plate, the claw‐shaped bone plate showed shorter operation time (102.73 ± 18.43 min vs. 156 ± 37.53, P < 0.0001), higher CMS (94.00 ± 4.07 vs. 89.88 ± 5.42, P = 0.02) and no differences between the two groups regarding intraoperative blood loss (208.00 ± 96.45 mL vs. 269.44 ± 120.21, P = 0.12) and clinical healing times (9.96 ± 1.52 vs. 10.05 ± 1.67, P = 0.87). Follow‐up were conducted at first, third, 6 and 12 months after surgery. The operation was successful in all patients with no intraoperative complications.ConclusionsFor the treatment of complex and unstable scapular neck body fractures, the application of claw‐shaped bone plate demonstrated short operation time, better stability of the fracture block, and higher CMS. In the intraoperative and postoperative follow‐up showed better clinical results and rehabilitation effects.
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