Malović Mario, Pavić Roman, Milosević Milan
Department of Hand Surgery, University Hospital of Traumatology, Draskovićeva 19, 10000 Zagreb, Croatia.
Mil Med. 2011 Sep;176(9):1077-82. doi: 10.7205/milmed-d-10-00419.
Trans-scaphoid perilunate fracture dislocations (TSPLD) are uncommon injuries and constitute about 3% of all carpal injuries. Up to 25% of these high energy trauma cases go undiagnosed. Presented are 43 (3 female, 40 male) consecutive patients treated for dorsal TSPLD, all were closed fractures. Patients were between 17 and 66 years old. Twenty male patients were injured in active duty military service. Surgical treatment was made with a volar approach using titanium cannulated headless compression screws (3.2 mm) placed via a guide wire. Repositioning the dislocated carpus is then conducted using 3 temporary fixation Kirschner wires (1.6 mm). The patient had a volar short arm splint for 4 weeks, then given an orthosis. Triple fixation Kirschner wires were removed 6-8 weeks postoperatively. Mean followup period was 29 months (range 20-38). The average Mayo wrist score for all 43 patients is 87 (good) (range 65-99). All patients returned to their previous employment.
经舟骨月骨周围骨折脱位（TSPLD）是一种罕见的损伤，约占所有腕骨损伤的3%。这些高能量创伤病例中，高达25%未被诊断出来。本文介绍了43例（3例女性，40例男性）连续接受背侧TSPLD治疗的患者，均为闭合性骨折。患者年龄在17至66岁之间。20名男性患者是在现役军事任务中受伤的。采用掌侧入路，通过导丝置入钛质无头空心加压螺钉（3.2毫米）进行手术治疗。然后使用3根临时固定克氏针（1.6毫米）对脱位的腕骨进行复位。患者佩戴掌侧短臂夹板4周，之后给予矫形器。术后6至8周取出三联固定克氏针。平均随访期为29个月（范围20至38个月）。43例患者的平均梅奥腕关节评分为87分（良好）（范围65至99分）。所有患者均恢复了先前的工作。
