摘要目的 分析翼状肩的发病率、发病原因、诊断方法及不同治疗方式.方法 在PubMed及EBSCO Medline Complete全文数据库中检索“winged scapula”,在中国知网、万方、维普数据中文数据库检索“翼状肩”,时间节点选取1958年至2017年,所有被检索的文献及参考文献均被用于分析,经文题、摘要、全文内容二次筛选,共筛选出36篇文献,将所涉及的翼状肩患者作为研究对象,删除重复报告的病例;收集每例入选患者的发病年龄、性别、发病原因、手术方式、随访时间、愈后等.采用系统分析的方法对数据进行分项研究.结果 筛选出的36篇文献中共356例翼状肩患者纳入研究进行系统分析,平均29岁,男女比例为49:40.前锯肌麻痹213例,其中治疗包括:物理锻炼16例,优11例,差5例,优秀率为68.8％;神经松解、移植70例,优50例,差20例,优秀率为71.4％;肩胛固定术3例,优1例,差2例,优秀率为33.3％;胸大肌腱转移术124例,其中优88例,差36例,优秀率为71％.斜方肌麻痹46例,治疗包括:物理锻炼14例,优12例,差2例,优秀率为86％;肩胛固定术1例,优1例,优秀率100％;Eden-Lange31例,优27例,差4例,优良率为87％.菱形肌麻痹1例,其中治疗包括:康复训练(超声辅导)1例,优1例,优秀率为100％.肌营养不良96例,治疗包括:肩胛固定术96例,优76例,差20例,优秀率79.1％.结论 翼状肩临床少见,真正发病率未知.不同发病原因决定不同的治疗方式:前锯肌麻痹更适合行胸大肌腱转移术,改良Eden-Lange术更多用于斜方肌麻痹的治疗.

abstractsObjective To study the morbidity,pathogenesis,diagnosis and treatment of winged scapula.Methods The key words about "winged scapula" have been used to search articles which include winged scapula patients in English and Chinese literature databases from 1958 to 2017.The articles have been filtrated by title,abstract and full text.There are 36 articles used for this study.All the patients are objects of this study,but the same patients' data in different articles have not been used repeatedly.The patients' data have been collected as much as possible,including age,sex,causes,treatment,follow-up and so on.All the patients' data have been used for systematic analysis.Results All of 356 patients with winged scapula were selected from 36 literatures for systematic analysis.There were 213 cases of anterior saw muscle paralysis,among which 16 cases were physical exercise,11 cases were excellent and 5 cases were poor,with an excellent rate of 68.8％.There were 70 cases of neurolysis and transplantation,50 cases were excellent and 20 cases were poor,with an excellent rate of 71.4％.There were 3 cases of scapulectomy,1 case excellent and 2 cases poor.There were 124 cases of pectoralis major tendon metastasis,88 cases were excellent,36 cases were poor,and the excellent rate was 71％.There were 46 cases of trapezius paralysis,among which 14 cases were physical exercise,12 cases were excellent,2 cases were poor,and the excellent rate was 86％.1 case of scapulopexy and 1 case of superior,with an excellent rate of 100％;There were 31 cases of Eden-Lange 31 cases,27 cases of excellent and 4 cases of poor.One case of rhomboid myoplegia was treated,including 1 case of rehabilitation training (ultrasound guidance),1 case of excellent,with an excellent rate of 100％.There were 96 cases of muscular dystrophy,including 96 cases of scapulectomy,76 cases of excellent and 20 cases of poor,with an excellent rate of 79.1％.Conclusion Winged scapula is rare and its incidence is unknown,different causes determine different treatments:Anterior saw muscle palsy is more suitable for thoracolumbar tendon transfer,and modified Eden-Lange is more suitable for trapezius palsy.