Herzberg G, Forissier D
Edouard Herriot Hospital, Orthopaedic Service, Lyon Cedex 03, France.
J Hand Surg Br. 2002 Dec;27(6):498-502. doi: 10.1054/jhsb.2002.0774.
The purpose of this study was to investigate the medium-term results (mean follow-up, 8 years) of a series of 14 trans-scaphoid dorsal perilunate fracture-dislocations treated operatively at an average of 6 days following injury. Eleven underwent open reduction and internal fixation through a dorsal approach. Combined palmar and dorsal approaches were used in only three cases, for open reduction and internal fixation in two and proximal row carpectomy in one. The Mayo wrist score revealed five excellent, three good, five fair and one poor result. The average score was 79% (range 55-95%). All internally fixed scaphoids healed and no lunate or scaphoid fragment avascular necrosis with collapse was observed. Carpal alignment was satisfactory in most cases. Post-traumatic radiological midcarpal and/or radiocarpal arthritis were almost always observed at follow-up, but this did not correlate with the Mayo wrist score.
本研究的目的是调查14例经舟骨月骨周围背侧骨折脱位患者的中期结果（平均随访8年），这些患者均在受伤后平均6天接受了手术治疗。其中11例通过背侧入路进行切开复位内固定。仅3例采用掌侧和背侧联合入路，2例行切开复位内固定，1例行近排腕骨切除术。Mayo腕关节评分显示，结果为优5例、良3例、中5例、差1例。平均评分为79%（范围为55%-95%）。所有内固定的舟骨均愈合，未观察到月骨或舟骨碎片缺血性坏死伴塌陷。大多数病例的腕骨对线满意。随访时几乎总能观察到创伤后放射性中腕关节和/或桡腕关节关节炎，但这与Mayo腕关节评分无关。
