中国骨伤
中國骨傷
중국골상
CHINA JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
2014年
3期
187-190
,共4页
舟骨%骨折%骨折固定术,内
舟骨%骨摺%骨摺固定術,內
주골%골절%골절고정술,내
Scaphoid bone%Fractures%Fracture fixation,internal
目的：总结经皮腕掌侧入路Herbert螺钉内固定治疗舟骨骨折的经验。方法：自2008年4月至2012年9月，采用经皮腕掌侧入路Herbert螺钉内固定治疗舟骨骨折15例，男14例，女1例；年龄25～45岁，平均35岁；左侧10例，右侧5例。患者自受伤至就诊时间3～10 d，平均5 d。术前均行常规X线及CT检查，所有舟骨骨折提示均为B2型骨折（Herbert分型）。根据腕关节功能Krimmer评分标准对所有患者术后腕关节功能恢复情况进行评价。结果：15例患者获随访，时间5～18个月，平均10个月。术后3个月内每月复查X线1次，骨折愈合时间7～14周，平均10周，螺钉位置良好。术后参考Krimmer评分标准进行腕关节功能评定，14例为100分，1例90分。所有患者腕掌小切口Ⅰ期愈合，无感染和骨不愈合等并发症发生。结论：经皮腕掌侧入路Herbert螺钉内固定治疗舟骨骨折是一种微创、骨折愈合率高、并发症相对较少的有效治疗方法。
目的：總結經皮腕掌側入路Herbert螺釘內固定治療舟骨骨摺的經驗。方法：自2008年4月至2012年9月，採用經皮腕掌側入路Herbert螺釘內固定治療舟骨骨摺15例，男14例，女1例；年齡25～45歲，平均35歲；左側10例，右側5例。患者自受傷至就診時間3～10 d，平均5 d。術前均行常規X線及CT檢查，所有舟骨骨摺提示均為B2型骨摺（Herbert分型）。根據腕關節功能Krimmer評分標準對所有患者術後腕關節功能恢複情況進行評價。結果：15例患者穫隨訪，時間5～18箇月，平均10箇月。術後3箇月內每月複查X線1次，骨摺愈閤時間7～14週，平均10週，螺釘位置良好。術後參攷Krimmer評分標準進行腕關節功能評定，14例為100分，1例90分。所有患者腕掌小切口Ⅰ期愈閤，無感染和骨不愈閤等併髮癥髮生。結論：經皮腕掌側入路Herbert螺釘內固定治療舟骨骨摺是一種微創、骨摺愈閤率高、併髮癥相對較少的有效治療方法。
목적：총결경피완장측입로Herbert라정내고정치료주골골절적경험。방법：자2008년4월지2012년9월，채용경피완장측입로Herbert라정내고정치료주골골절15례，남14례，녀1례；년령25～45세，평균35세；좌측10례，우측5례。환자자수상지취진시간3～10 d，평균5 d。술전균행상규X선급CT검사，소유주골골절제시균위B2형골절（Herbert분형）。근거완관절공능Krimmer평분표준대소유환자술후완관절공능회복정황진행평개。결과：15례환자획수방，시간5～18개월，평균10개월。술후3개월내매월복사X선1차，골절유합시간7～14주，평균10주，라정위치량호。술후삼고Krimmer평분표준진행완관절공능평정，14례위100분，1례90분。소유환자완장소절구Ⅰ기유합，무감염화골불유합등병발증발생。결론：경피완장측입로Herbert라정내고정치료주골골절시일충미창、골절유합솔고、병발증상대교소적유효치료방법。
Objective:To summarize the experience of percutaneous fixation of scaphoid fractures with Herbert screws through volar approach,and provide a reliable and efficient treatment method for scaphoid fractures. Methods:From April 2008 to September 2012,15 patients with scaphoid fractures were treated by percutaneous fixation with Herbert cannulated screws through volar approach including 14 males and 1 female with an average age of 35 years ranging from 25 to 45 years old. Among them,10 cases were on left side and 5 cases were on right side. Durations from injury to operation ranged from 3 to 10 days with an average of 5 days. All these cases were identified as B2 type according to the Herbert classification based on X ray and CT scan. In order to assess the function of wrist ,all patients were calculated according to Krimmer's score postoperatively. Results:The follow up period were from 5 to 18 months with an average of 10 months. At 3 months after operation ,X ray was re checked every month. All the patients achieved bone union with a mean time of 10 weeks (ranged from 7 to 14 weeks) post-operatively. According to Krimmer's score ,14 cases gained 100 scores as perfect and one case got 90 scores as good. The small volar incision of all patients were union at the first period. No operation complications such as infection and nonunion occurred. Conclusion:Percutaneous fixation with Herbert cannulated screws through volar approach is a reliable and efficient treatment method for scaphoid fractures with small invasion,high bone union rate,and fewer complications.
