Dunn John, Kusnezov Nicholas, Fares Austin, Mitchell Justin, Pirela-Cruz Miguel
1 William Beaumont Army Medical Center, Fort Bliss, TX, USA.
2 Creighton University School of Medicine, Omaha, NE, USA.
Hand (N Y). 2017 May;12(3):236-241. doi: 10.1177/1558944716658747. Epub 2016 Jul 7.
The purpose of this systematic review is to analyze the indications, outcomes, and complications of scaphoid fixation with a staple.
The literature was reviewed for all cases of the scaphoid staple. Five articles including 188 patients, of 77 primary scaphoid fractures and 111 other indications that included delayed union, nonunion, and avascular necrosis, were reviewed. Demographic data, outcomes, and complications were recorded.
The union rate of the scaphoid staple is 94.7%, and 95.7% of patients return to work after an average of 9.8 weeks after a 4.7-week period of immobilization. The complication rate was 9.0%, and 7.5% required hardware removal. Clinical and radiographic healing was higher in primary fractures as compared with other indications. Other indications, as compared with primary fracture, had a higher rate of hardware removal.
For all indications, the scaphoid staple has a high union rate and a low complication rate. In the authors' experience, the procedure is fast, not technically challenging, and may be considered for primary fracture, delayed union, nonunion, and avascular necrosis of the scaphoid.
本系统评价的目的是分析使用吻合钉固定舟骨的适应证、治疗结果及并发症。
对所有使用舟骨吻合钉的病例的文献进行回顾。共纳入5篇文章，包含188例患者，其中77例为新鲜舟骨骨折，111例为其他适应证，包括骨折延迟愈合、不愈合及缺血性坏死。记录患者的人口统计学数据、治疗结果及并发症。
舟骨吻合钉的骨折愈合率为94.7%，95.7%的患者在平均4.7周的固定期后，经过平均9.8周可恢复工作。并发症发生率为9.0%，7.5%的患者需要取出内固定物。与其他适应证相比，新鲜骨折的临床及影像学愈合情况更好。与新鲜骨折相比，其他适应证的内固定物取出率更高。
对于所有适应证，舟骨吻合钉均具有较高的骨折愈合率及较低的并发症发生率。根据作者的经验，该手术操作快速，技术难度不高，可用于新鲜舟骨骨折、骨折延迟愈合、不愈合及缺血性坏死的治疗。
