Amirfeyz R, Bebbington A, Downing N D, Oni J A, Davis T R C
Department of Trauma and Orthopaedic Surgery, Queens Medical Centre, University Hospital, Nottingham, UK.
J Hand Surg Eur Vol. 2011 Jul;36(6):498-502. doi: 10.1177/1753193411403092. Epub 2011 Apr 5.
This study assessed whether nonunion of displaced scaphoid waist fractures with nonoperative treatment could be predicted from 4 week CT scans. Thirty-one patients with unilateral displaced scaphoid waist fractures and adequate follow-up were included. CT scans in the longitudinal axis of the scaphoid with sagittal and coronal slices were done 4 weeks after the index injury. The effects of fracture gap, sclerosis and bone resorption on union were assessed. Fracture union was observed in all 13 displaced fractures with a < 2 mm gap, four of the seven with a gap of 2-3 mm and only four of the 11 with a gap > 3 mm (p = 0.01). Bone resorption involving more than 50% of the fracture cross-section was also associated with nonunion, but sclerosis was not.
本研究评估了能否根据伤后4周的CT扫描来预测非手术治疗的舟状骨腰部移位骨折不愈合情况。纳入了31例单侧舟状骨腰部移位骨折且随访充分的患者。在伤后4周对舟状骨纵轴进行矢状位和冠状位CT扫描。评估骨折间隙、硬化及骨吸收对骨折愈合的影响。13例骨折间隙<2mm的移位骨折均实现骨折愈合，7例间隙为2-3mm的骨折中有4例愈合，而11例间隙>3mm的骨折中仅有4例愈合（p=0.01）。骨折断面骨吸收超过50%也与骨折不愈合相关，但硬化则不然。
