Gellman H, Caputo R J, Carter V, Aboulafia A, McKay M
Department of Orthopaedic Surgery, University of Southern California, Los Angeles 90007.
J Bone Joint Surg Am. 1989 Mar;71(3):354-7.
A prospective study was undertaken of fifty-one patients who were randomly assigned to treatment with either a long or a short thumb-spica cast for a non-displaced fracture of the carpal scaphoid. The duration of follow-up was at least until union; the average follow-up was twelve months. Twenty-eight fractures were treated with a long thumb-spica cast and twenty-three, with a short thumb-spica cast. The hands that initially were treated with a long thumb-spica cast were placed in a short thumb-spica cast after six weeks. Fractures that initially were treated with a long thumb-spica cast united at an average of 9.5 weeks and those that were maintained in a short thumb-spica cast, at an average of 12.7 weeks. There were no non-unions and two delayed unions in the fractures that initially were treated with a long thumb-spica cast, compared with two non-unions and six delayed unions in those that had only a short thumb-spica cast. Fractures of the proximal or middle third of the carpal scaphoid had a significantly shorter time to union when they were treated initially in a long thumb-spica cast. Fractures of the distal third did well regardless of the type of immobilization.(ABSTRACT TRUNCATED AT 250 WORDS)
对51例腕舟骨无移位骨折患者进行了一项前瞻性研究，这些患者被随机分配接受长或短拇指人字形石膏治疗。随访时间至少持续至骨折愈合；平均随访时间为12个月。28例骨折采用长拇指人字形石膏治疗，23例采用短拇指人字形石膏治疗。最初接受长拇指人字形石膏治疗的手在6周后更换为短拇指人字形石膏。最初接受长拇指人字形石膏治疗的骨折平均在9.5周时愈合，而一直使用短拇指人字形石膏治疗的骨折平均在12.7周时愈合。最初接受长拇指人字形石膏治疗的骨折中没有出现骨不连，有2例延迟愈合；相比之下，仅接受短拇指人字形石膏治疗的骨折中有2例骨不连和6例延迟愈合。腕舟骨近端或中部三分之一处的骨折，最初采用长拇指人字形石膏治疗时，愈合时间明显缩短。无论采用何种固定方式，远端三分之一处的骨折愈合情况良好。（摘要截取自250字）
