Department of Orthopaedic Surgery, Taoyuan Armed Forces General Hospital, Taoyuan County, Taiwan.
Arthroscopy. 2011 Jan;27(1):31-7. doi: 10.1016/j.arthro.2010.05.015. Epub 2010 Oct 8.
The purpose of this study was to analyze the clinical follow-up results (minimum, 2 years) in patients with nonunions of the scaphoid with minimal sclerosis treated with arthroscopically assisted percutaneous internal fixation augmented by injection of a bone graft substitute.
From January 2006 through November 2007, a consecutive series of 15 patients with fibrous union or nonunion of a carpal scaphoid fracture with minimal sclerosis or resorption at the nonunion site were treated with arthroscopically assisted percutaneous internal fixation combined with the use of injectable bone graft substitute. Preoperative and postoperative evaluations included measurement of clinical (grip strength and range of motion), radiographic, and functional (Mayo Modified Wrist Score) parameters, as well as satisfaction. The sample included 13 men and 2 women with a mean age of 31 years (range, 20 to 45 years). We recorded union and return to activity and analyzed data with regular clinical follow-up at a mean of 33 months (range, 24 to 46 months).
We confirmed union in 14 of 15 patients (93%) at a mean of 15.4 weeks according to clinical examinations and standard radiography. For the Mayo Modified Wrist Score, there were 10 excellent and 4 good results. A total of 14 of 15 patients (93%) returned to work or sports activities at their preinjury level.
Arthroscopically assisted treatment with percutaneous internal fixation with injectable bone graft substitute is a reliable and minimally invasive method to achieve union and scaphoid healing.
Level IV, therapeutic case series.
本研究旨在分析经关节镜辅助经皮内固定联合注射骨移植替代物治疗非硬化性腕舟骨骨不连患者的临床随访结果（最少 2 年）。
2006 年 1 月至 2007 年 11 月，连续 15 例腕舟骨骨折纤维性或骨不连患者，伴有最小程度的硬化或非愈合部位的吸收，采用关节镜辅助经皮内固定联合注射可注射骨移植替代物治疗。术前和术后评估包括临床（握力和活动范围）、影像学和功能（改良 Mayo 腕关节评分）参数以及满意度的测量。该样本包括 13 名男性和 2 名女性，平均年龄 31 岁（范围 20 至 45 岁）。我们记录了愈合和恢复活动情况，并在平均 33 个月（范围 24 至 46 个月）的定期临床随访中分析数据。
根据临床检查和标准影像学，我们确认 15 例患者中的 14 例（93％）在平均 15.4 周时达到愈合。改良 Mayo 腕关节评分中，10 例为优，4 例为良。15 例患者中有 14 例（93％）完全恢复工作或运动活动，达到受伤前的水平。
关节镜辅助经皮内固定联合注射骨移植替代物是一种可靠且微创的方法，可以实现愈合和舟骨愈合。
IV 级，治疗性病例系列。
