Garcia-Elias M, Dobyns J H, Cooney W P, Linscheid R L
Department of Orthopedics, Mayo Clinic/Mayo Foundation, Rochester, Minn 55905.
J Hand Surg Am. 1989 May;14(3):446-57. doi: 10.1016/s0363-5023(89)80003-6.
Among 1140 patients treated in the last 16 years for any type of carpal fracture, dislocation, or subluxation, 16 (1.4%) patients seen with a traumatic axial disruption of both the carpus and metacarpus were identified. Most of these were crush or blast injuries. According to the direction of instability, the cases were classified into three groups: axial-ulnar disruptions (4 patients), axial-radial disruptions (11 patients), and combined axial-radial-ulnar disruption (1 patient). Treatment consisted of open reduction and percutaneous Kirschner-wire fixation in most cases. The results were less optimistic than suggested in the literature. An average follow-up of 61 months showed that prognosis was determined more by the associated soft tissue injuries than by the carpal derangement itself. Early management of both the skeletal and soft tissue components of the injury seems most effective.
在过去16年中因任何类型的腕骨骨折、脱位或半脱位接受治疗的1140例患者中，发现有16例（1.4%）患者存在腕骨和掌骨的创伤性轴向断裂。其中大多数为挤压伤或爆炸伤。根据不稳定的方向，这些病例被分为三组：轴向尺侧断裂（4例）、轴向桡侧断裂（11例）和轴向桡尺侧联合断裂（1例）。大多数病例的治疗包括切开复位和经皮克氏针固定。结果并不像文献中所暗示的那样乐观。平均随访61个月显示，预后更多地取决于相关的软组织损伤，而非腕骨紊乱本身。对损伤的骨骼和软组织成分进行早期处理似乎最为有效。
