Garcia Ryan M, Ruch David S
Department of Orthopaedic Surgery, Section of Hand, Upper Extremity, and Microvascular Surgery, Duke University Medical Center, Durham, NC.
Sports Med Arthrosc Rev. 2014 Mar;22(1):22-8. doi: 10.1097/JSA.0000000000000008.
Scaphoid fractures occur commonly in the athlete and should be treated with urgency to avoid undesired late complications. Magnetic resonance imaging may be helpful to make a prompt diagnosis so that an appropriate early treatment plan can be initiated. Cast immobilization in acute, nondisplaced scaphoid fractures seems to have an equivalent union rate to surgical modalities. Despite this, limiting the immobilization and time to union period in the athlete will allow earlier restoration of preinjury level function and eventual return to play. Percutaneous techniques with or without arthroscopy assistance have been advocated as less invasive surgical approaches that may have an added benefit in the athlete. Displaced and unstable fractures should be approached with a volar or dorsal open technique to achieve and confirm an anatomic reduction before screw placement.
舟骨骨折在运动员中很常见，应及时治疗以避免出现不良的晚期并发症。磁共振成像可能有助于迅速做出诊断，从而启动适当的早期治疗方案。急性无移位舟骨骨折采用石膏固定，其愈合率似乎与手术方式相当。尽管如此，限制运动员的固定时间和愈合时间将有助于更早恢复伤前的功能水平并最终重返赛场。有人主张采用有或没有关节镜辅助的经皮技术，作为侵入性较小的手术方法，这可能对运动员有额外的益处。对于移位和不稳定骨折，应采用掌侧或背侧开放技术，在置入螺钉前实现并确认解剖复位。
