Geurts Ghislain F A E, Van Riet Roger P, Meermans Geert, Verstreken Frederik
Department of Orthopaedics and Traumatology, Monica Research (MoRe) Foundation, Monica Hospital Deurne, Antwerp, Belgium.
Acta Orthop Belg. 2012 Feb;78(1):121-5.
Percutaneous screw fixation of scaphoid fractures has gained popularity over the years. The disadvantages of a long period of cast immobilisation are avoided and this technique allows a more rapid return to work and sports activities than conservative treatment. Consequently, percutaneous screw fixation is appealing for the young and active population. Biomechanical studies showed that greater fixation strength is obtained when the screw is placed centrally than eccentrically. Central screw placement can however be technically demanding. In the use of a volar percutaneous approach, the trapezium and the shape of the scaphoid impede central screw placement. Different approaches are available to overcome this difficulty. The volar percutaneous transtrapezial approach facilitates and allows more accurate central screw placement compared to approaches that try to avoid the trapezium. The surgical technique of this approach is described.
多年来，经皮螺钉固定舟骨骨折越来越受欢迎。它避免了长时间石膏固定的缺点，与保守治疗相比，该技术能使患者更快地恢复工作和体育活动。因此，经皮螺钉固定对年轻且活跃的人群具有吸引力。生物力学研究表明，螺钉置于中心位置时比偏心放置能获得更大的固定强度。然而，中心螺钉置入在技术上要求较高。在使用掌侧经皮入路时，大多角骨和舟骨的形状会妨碍中心螺钉的置入。有多种不同的入路可用于克服这一困难。与试图避开大多角骨的入路相比，掌侧经皮经大多角骨入路有助于并能实现更精确的中心螺钉置入。本文描述了该入路的手术技术。
