Department of Orthopaedic Surgery, Chang Gung Memorial Hospital & University, 5, Fu-Shin Street, Kweishan, Taoyuan 333, Taiwan.
Injury. 2010 Jun;41(6):e10-4. doi: 10.1016/j.injury.2009.07.078. Epub 2009 Dec 24.
Scaphoid fractures are among the most common types of carpal bone injury; they can be easily overlooked in the acute stage. Scaphoid fractures detected in the subacute stage require a more meticulous and prompt approach, to prevent chronicity and regain wrist function.
The records of 30 patients were selected from 97 with scaphoid fractures surgically treated between 1994 and 2002. Fractures that were diagnosed between 2 weeks and 5 months (average, 2.2 months) after the injury were included. We report the fracture patterns and locations, as determined from radiographs, as well as the surgical methods used. The mean follow-up was 2.5 years.
Oblique fractures (60%) were the most commonly overlooked fractures. Twenty-six patients (87%) underwent open surgery, and 23 (77%) required bone grafts. Percutaneous fixation was indicated for only four patients, whose fractures were reducible via either fluoroscopic or arthroscopic guidance. Osseous unions were achieved for 29 (97%) patients; these patients returned to their pre-injury level of activity. The average union time was 10.6 weeks.
Oblique-type scaphoid fractures are potentially unstable and may result in detrimental sequelae if overlooked in the acute stage. Accurate diagnosis is possible through critical skepticism and the meticulous scrutiny of radiographs. Prompt surgical intervention is associated with promising outcomes.
舟状骨骨折是最常见的腕骨损伤类型之一；在急性期很容易被忽视。亚急性期发现的舟状骨骨折需要更细致、更及时的处理，以防止其慢性化并恢复腕关节功能。
从 1994 年至 2002 年间手术治疗的 97 例舟状骨骨折患者中选择了 30 例患者的记录。纳入的骨折为受伤后 2 周到 5 个月（平均 2.2 个月）确诊的骨折。我们报告了根据 X 线片确定的骨折类型和位置，以及所采用的手术方法。平均随访时间为 2.5 年。
斜形骨折（60%）是最容易被忽视的骨折。26 例（87%）患者接受了开放性手术，23 例（77%）需要植骨。只有 4 例患者需要经皮固定，这些患者的骨折可通过透视或关节镜引导复位。29 例（97%）患者实现了骨愈合；这些患者恢复到了受伤前的活动水平。平均愈合时间为 10.6 周。
斜形舟状骨骨折具有潜在的不稳定性，如果在急性期被忽视，可能会导致不良后果。通过批判性怀疑和仔细审查 X 线片可以做出准确诊断。及时的手术干预与良好的预后相关。
