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舟骨骨折的微创治疗:从新鲜骨折到骨不连

Minimal invasive management of scaphoid fractures: from fresh to nonunion.

作者信息

Wong W Y Clara, Ho P C

机构信息

Department of Orthopaedics and Traumatology, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong.

出版信息

Hand Clin. 2011 Aug;27(3):291-307. doi: 10.1016/j.hcl.2011.06.003.

Abstract

The peculiar shape of scaphoid hinders a precise evaluation of its fracture configuration, displacement and accuracy of screw placement. Its tenuous vascular supply risks the complications of delayed union, nonunion and avascular necrosis. Scaphoid is the focus of ligamentous attachment governing carpal kinematics. Preservation of its anatomy and vascularity is critical for normal wrist function. A new fracture classification clearly denoting every fracture type and guiding the management is introduced. The minimal invasive management of different scaphoid fracture conditions, including acute non-displaced and displaced fracture, delayed presentation, and nonunion are discussed. Role of arthroscopy is emphasized. Detailed surgical techniques are shared here.

摘要

舟骨独特的形状妨碍了对其骨折形态、移位情况及螺钉置入准确性的精确评估。其薄弱的血供存在延迟愈合、不愈合及缺血性坏死等并发症的风险。舟骨是控制腕关节运动学的韧带附着点的关键部位。保留其解剖结构和血供对于腕关节的正常功能至关重要。本文介绍了一种新的骨折分类方法,该方法能清晰地表明每种骨折类型并指导治疗。文中还讨论了不同舟骨骨折情况的微创治疗,包括急性无移位和有移位骨折、延迟就诊及不愈合等情况。强调了关节镜检查的作用。在此分享详细的手术技术。

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