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急性舟骨骨折:一项批判性分析综述

Acute Scaphoid Fractures: A Critical Analysis Review.

作者信息

Tait Mark A, Bracey John W, Gaston R Glenn

机构信息

OrthoCarolina Hand Center, Charlotte, North Carolina.

出版信息

JBJS Rev. 2016 Sep 20;4(9). doi: 10.2106/JBJS.RVW.15.00073.

Abstract

Nondisplaced scaphoid fractures can be effectively treated nonoperatively, with union rates approaching or, in some series, exceeding the rates attained with operative intervention. The evidence supports equal outcomes when using a short arm or long arm cast for the closed treatment of nondisplaced scaphoid fractures. Also, equivalent outcomes have been demonstrated with or without a thumb spica component to the cast. Operative intervention is the recommended treatment for displaced scaphoid fractures. Advanced imaging should be obtained if clinical suspicion is present for a scaphoid fracture with negative radiographs more than 2 weeks after the injury. In some settings, it may even be more cost-effective to obtain advanced imaging sooner.

摘要

无移位的舟骨骨折可以通过非手术方法有效治疗,其愈合率接近或在某些系列研究中超过手术干预所达到的愈合率。有证据表明,使用短臂或长臂石膏对无移位的舟骨骨折进行闭合治疗时,疗效相当。此外,无论石膏是否带有拇指人字形固定部件,都已证明疗效相当。手术干预是移位舟骨骨折的推荐治疗方法。如果受伤超过2周后临床怀疑有舟骨骨折而X线片为阴性,应进行高级影像学检查。在某些情况下,尽早进行高级影像学检查甚至可能更具成本效益。

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