Tait Mark A, Bracey John W, Gaston R Glenn
OrthoCarolina Hand Center, Charlotte, North Carolina.
JBJS Rev. 2016 Sep 20;4(9). doi: 10.2106/JBJS.RVW.15.00073.
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.
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。