Kahl T, Razny F K, Benter J P, Mutig K, Hegenscheid K, Mutze S, Eisenschenk A
Institut für Radiologie und Neuroradiologie, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Deutschland.
Institut für vegetative Anatomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
Orthopade. 2016 Nov;45(11):938-944. doi: 10.1007/s00132-016-3333-y.
The clinical relevance of scaphoid bone fractures is reflected by their high incidence, accounting for approximately 60 % among carpal fractures and for 2-3 % of all fractures. With adequate therapy most scaphoid bone fractures heal completely without complications. Insufficient immobilization or undiagnosed fractures increase the risk of nonunion and the development of pseudarthrosis.X-ray examination enables initial diagnosis of scaphoid fracture in 70-80 % of cases. Positive clinical symptoms by negative x‑ray results require further diagnostics by multi-slice spiral CT (MSCT) or MRI to exclude or confirm a fracture. In addition to the diagnosis and description of fractures MSCT is helpful for determining the stage of nonunion. Contrast enhanced MRI is the best method to assess the vitality of scaphoid fragments.
舟骨骨折的临床相关性体现在其高发病率上，约占腕骨骨折的60%，占所有骨折的2-3%。通过适当治疗，大多数舟骨骨折可完全愈合且无并发症。固定不充分或骨折未被诊断会增加骨不连和假关节形成的风险。X线检查能在70-80%的病例中实现舟骨骨折的初步诊断。X线结果为阴性但有阳性临床症状时，需要通过多层螺旋CT（MSCT）或MRI进行进一步诊断，以排除或确认骨折。除了骨折的诊断和描述外，MSCT有助于确定骨不连的阶段。增强MRI是评估舟骨碎片活力的最佳方法。
