Ek Eugene T, Wang Kemble
Division of Hand Surgery, Department of Orthopaedics, Dandenong Hospital, Melbourne, Victoria, Australia; Department of Surgery, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia; Melbourne Orthopaedic Group, Windsor, Victoria, Australia.
Division of Hand Surgery, Department of Orthopaedics, Dandenong Hospital, Melbourne, Victoria, Australia; Department of Surgery, Monash Medical Centre, Monash University, Melbourne, Victoria, Australia; Melbourne Orthopaedic Group, Windsor, Victoria, Australia.
J Hand Surg Am. 2017 Sep;42(9):758.e1-758.e4. doi: 10.1016/j.jhsa.2017.06.011. Epub 2017 Jul 12.
Surgical treatment of ultrasmall proximal pole scaphoid fractures poses a number of challenges. The fragment may be too small to fix with conventional headless screw fixation owing to the high risk of fragmentation upon insertion. However, excision of the fragment risks compromising the scapholunate ligament complex and also exposes the radioscaphoid joint to potential degenerative changes. Under these circumstances, we describe the use of bioabsorbable osteochondral fixation nails that allows stable low-profile fixation while minimizing the risk of fracturing the proximal pole.
超小的舟骨近极骨折的手术治疗面临诸多挑战。由于插入时骨折的风险较高,骨折块可能太小,无法用传统的无头螺钉固定。然而,切除骨折块有损害舟月韧带复合体的风险,并且还会使桡舟关节面临潜在的退行性改变。在这种情况下,我们描述了使用可生物吸收的骨软骨固定钉,它能实现稳定的低轮廓固定,同时将近端极骨折的风险降至最低。