Dana C, Doursounian L, Nourissat G
Unité de chirurgie du membre supérieur, service de chirurgie orthopédique, hôpital universitaire Saint-Antoine, AP-HP, université Pierre-et-Marie-Curie-Paris 6, Paris, France.
Chir Main. 2010 Apr;29(2):114-7. doi: 10.1016/j.main.2010.01.001. Epub 2010 Feb 23.
Fractures of the lunate bone are rare and usually treated by prolonged immobilization. We report a fracture of the dorsal pole of the lunate bone detaching the scapholunate ligament. The clinical presentation was equivalent to an acute disruption of this ligament. Percutaneous screw repair of the bone fragment was performed under wrist arthroscopy. The patient kept an analgesic splint for five days and early mobilization was provided. After 6 weeks, the patient had returned to his previous level of activity with normal wrist motion and full strength. Screw fixation under arthroscopy is minimally invasive and provides accurate restoration of the lunar anatomy, yielding good functional results after a short recovery period. This treatment offers a satisfactory alternative to prolonged immobilization and ensures good reduction and compression of the fracture. We present a detailed description of the surgical technique and its results.
月骨骨折较为罕见,通常采用长期固定治疗。我们报告一例月骨背侧极骨折,伴有舟月韧带分离。临床表现与该韧带急性断裂相当。在腕关节镜下对骨块进行了经皮螺钉修复。患者佩戴镇痛夹板五天,并进行了早期活动。六周后,患者恢复到之前的活动水平,腕关节活动正常,力量完全恢复。关节镜下螺钉固定微创,能准确恢复月骨解剖结构,在短恢复期后产生良好的功能结果。这种治疗方法为长期固定提供了令人满意的替代方案,并确保骨折得到良好复位和加压。我们对手术技术及其结果进行了详细描述。