ПЕРЕЛОМЫ ЛОПАТКИ практикум для врачей интернов и ординаторов

ПЕРЕЛОМЫ ЛОПАТКИ практикум для врачей интернов и ординаторов

Переломы лопатки (классификация) • Схема переломов лопатки: • 1 — суставной впадины; • 2 — клювовидного отростка • 3 — акромиона. • 4 – тела • 5 — медиального края; 6 — нижнего угла; • 7 - суставного отростка

Перелом суставного отростка

Перелом шейки лопатки

Перелом тела лопатки

Перелом акромиального отростка

• • • Type I, fractures of the glenoid rim; – type IA, Anterior rim fracture; – type IB, Posterior rim fracture Type II – Fracture line through the glenoid fossa exiting at the lateral border of the scapula Type III – Fracture line through the glenoid fossa exiting at the superior border of the scapula Type IV – Fracture line through the glenoid fossa exiting at the medial border of the scapula Type IV fracture in combinaion with other fracture patterns – Type VA – Combination of types II and IV – Type VB – Combination of types III and IV – Type VC – Combination of types II, III, and IV • Type VI – Comminuted fracture

Перелом клювовидного отростка

«Плавающее плечо» • The term floating shoulder refers to when a clavicle fracture or AC separation is coupled with a fracture of the scapula. There a few variation of the floating shoulder fracture pattern. Because conservative treatment may result in displacement (medialization) of the shoulder girdle, a floating shoulder is usually thought to represent an unstable injury pattern that requires operative stabilization.

«Плавающее плечо» • Figure 1. As described by Goss, * the superior shoulder suspensory complex consists of a bone and softtissue ring consisting of the glenoid, coracoid process, coracoclavicular ligaments (conoid and trapezoid), distal part of the clavicle, acromioclavicular joint, and acromion process. Some authors feel that the CA ligament should also be included as part of the complex.

«Плавающее плечо» • The superior shoulder suspensory complex (Figure 1) consists of a bone and soft-tissue ring. Injuries to the shoulder may often be treated conservatively if only one structure of the shoulder suspensory complex is disrupted. However, disruption of two or more elements usually leads to an unstable shoulder (Figures 2 and 3), and operative treatment may be necessary to achieve a good functional result.

«Плавающее плечо» • Figure 2. The floating shoulder. Note that the shoulder suspensory complex as seen in Figure 1 has been disrupted by the injury. The shoulder may become unstable if more than one element of the shoulder suspensory complex has been disrupted. In this case, surgery may be recommended

«Плавающее плечо»