Pichler Wolfgang, Windisch Gunther, Schaffler Gottfried, Heidari Nima, Dorr Katrin, Grechenig Wolfgang
Department of Traumatology, Medical University of Graz, Graz, Austria.
Orthopedics. 2010 Feb;33(2):85-8. doi: 10.3928/01477447-20100104-16.
Scaphoid fracture fixation using a cannulated headless compression screw and the Matti-Russe procedure for the treatment of scaphoid nonunions are performed routinely. Surgeons performing these procedures need to be familiar with the anatomy of the scaphoid. A literature review reveals relatively few articles on this subject. The goal of this anatomical study was to measure the scaphoid using current technology and to discuss the findings with respect to the current, relevant literature.Computed tomography scans of 30 wrists were performed using a 64-slice SOMATOM Sensation CT system (resolution 0.6 mm) (Siemens Medical Solutions Inc, Malvern, Pennsylvania). Three-dimensional reconstructions from the raw data were generated by MIMICS software (Materialise, Leuven, Belgium). The scaphoid had a mean length of 26.0 mm (range, 22.3-30.7 mm), and men had a significantly longer (P<.001) scaphoid than women (27.861.6 mm vs 24.561.6 mm, respectively). The width and height were measured at 3 different levels for volume calculations, resulting in a mean volume of 3389.5 mm(3). Men had a significantly larger (P<.001) scaphoid volume than women (4057.86740.7 mm(3) vs 2846.56617.5 mm(3), respectively).We found considerable variation in the length and volume of the scaphoid in our cohort. We also demonstrated a clear correlation between scaphoid size and sex. Surgeons performing operative fixation of scaphoid fractures and corticocancellous bone grafting for nonunions need to be familiar with these anatomical variations.
使用空心无头加压螺钉固定舟状骨骨折以及采用马蒂 - 鲁塞手术治疗舟状骨不愈合是常规操作。进行这些手术的外科医生需要熟悉舟状骨的解剖结构。文献综述显示关于该主题的文章相对较少。本解剖学研究的目的是使用当前技术测量舟状骨,并结合当前相关文献讨论研究结果。
使用64层SOMATOM Sensation CT系统(分辨率0.6毫米)(西门子医疗解决方案公司,宾夕法尼亚州马尔文)对30例腕关节进行计算机断层扫描。通过MIMICS软件(Materialise,比利时鲁汶)从原始数据生成三维重建图像。舟状骨平均长度为26.0毫米(范围22.3 - 30.7毫米),男性的舟状骨明显长于女性(分别为27.8 ± 1.6毫米和24.5 ± 1.6毫米,P <.001)。在3个不同水平测量宽度和高度以计算体积,平均体积为3389.5立方毫米。男性的舟状骨体积明显大于女性(分别为4057.8 ± 740.7立方毫米和2846.5 ± 617.5立方毫米,P <.001)。
我们发现我们研究队列中舟状骨的长度和体积存在相当大的差异。我们还证明了舟状骨大小与性别之间存在明显的相关性。进行舟状骨骨折手术固定和不愈合的皮质骨松质骨移植的外科医生需要熟悉这些解剖学变异。