Mao Hai-Jiao, Liu Zhen-Xin
Zhongguo Gu Shang. 2014 Mar;27(3):187-90.
To summarize the experience of percutaneous fixation of scaphoid fractures with Herbert screws through volar approach, and provide a reliable and efficient treatment method for scaphoid fractures.
From April 2008 to September 2012,15 patients with scaphoid fractures were treated by percutaneous fixation with Herbert cannulated screws through volar approach including 14 males and 1 female with an average age of 35 years ranging from 25 to 45 years old. Among them, 10 cases were on left side and 5 cases were on right side. Durations from injury to operation ranged from 3 to 10 days with an average of 5 days. All these cases were identified as B2 type according to the Herbert classification based on X-ray and CT scan. In order to assess the function of wrist, all patients were calculated according to Krimmer's score postoperatively.
The follow-up period were from 5 to 18 months with an average of 10 months. At 3 months after operation,X-ray was re-checked every month. All the patients achieved bone union with a mean time of 10 weeks (ranged from 7 to 14 weeks) postoperatively. According to Krimmer's score, 14 cases gained 100 scores as perfect and one case got 90 scores as good. The small volar incision of all patients were union at the first period. No operation complications such as infection and nonunion occurred.
Percutaneous fixation with Herbert cannulated screws through volar approach is a reliable and efficient treatment method for scaphoid fractures with small invasion, high bone union rate, and fewer complications.
总结经掌侧入路使用Herbert螺钉经皮固定舟骨骨折的经验,为舟骨骨折提供一种可靠、有效的治疗方法。
2008年4月至2012年9月,对15例舟骨骨折患者采用经掌侧入路Herbert空心螺钉经皮固定治疗,其中男14例,女1例,平均年龄35岁(25~45岁)。左侧10例,右侧5例。受伤至手术时间为3~10天,平均5天。根据X线和CT扫描的Herbert分类,所有病例均为B2型。为评估腕关节功能,术后对所有患者按Krimmer评分进行计算。
随访时间5~18个月,平均10个月。术后3个月内每月复查X线。所有患者均获得骨愈合,术后平均愈合时间为10周(7~14周)。按Krimmer评分,14例为优(100分),1例为良(90分)。所有患者掌侧小切口均一期愈合。未发生感染、骨不连等手术并发症。
经掌侧入路Herbert空心螺钉经皮固定治疗舟骨骨折是一种可靠、有效的治疗方法,具有创伤小、骨愈合率高、并发症少等优点。