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一种用于急性移位舟状骨骨折的新型经皮复位及维持和螺钉固定方法:至少两年随访

A novel percutaneous achievement and maintenance of reduction and screw fixation for acute displaced scaphoid fractures: minimum two-year follow-up.

作者信息

Yu Yadong, Cui Haibin, Yang Xiaoliang, Yu Xiaofei, Bai Yanbin

机构信息

Hand Surgery, The Third Hospital Of Hebei Medical University, No.139, Ziqiang Road, Qiaoxi District, Shijiazhuang, Hebei, 050051, People's Republic of China.

出版信息

Int Orthop. 2018 Aug;42(8):1911-1916. doi: 10.1007/s00264-018-3758-5. Epub 2018 Jan 10.

Abstract

PURPOSE

The purpose of this study was to introduce a novel method of percutaneous achievement and maintenance of reduction for acute displaced scaphoid fractures and evaluate the feasibility of this method in treating acute displaced scaphoid fractures as well as explore its indications.

METHODS

From February 2012 to March 2014, 15 patients with acute displaced scaphoid fractures were treated with our technique. Two Kirschner wires were used to achieve and maintain the reduction of the scaphoid fractures throughout the entire process of the traditional percutaneous screw fixation process. The following parameters including function scores according to modified Mayo wrist scoring system, range of motion (ROM) of the wrist, grip strength, pinch strength, healing time, time to return to work, and final outcomes were recorded.

RESULT

All patients were followed up with a mean period of 2.5 years (range, 2-3.5 years). All fractures healed with a mean of 9.3 weeks (range, 7-11.5 weeks). All patients returned to pre-injury level of activity within six weeks. The functional scores averaged 90.3 (range, 80-100). ROM of the wrist was equal to that of the contralateral side at three months postoperatively. Grip strength and pinch strength compared with contralateral were 98% and 92%, respectively. All were satisfied with the final outcomes.

CONCLUSIONS

Our technique is successfully performed in acute displaced scaphoid fractures resulting in shortened immobilization and prompt functional recovery. It broadens the indications of the percutaneous method, which means the advantages of the percutaneous method are maximally reserved whilst the drawbacks of open reduction were avoided.

摘要

目的

本研究旨在介绍一种经皮实现并维持急性移位舟骨骨折复位的新方法,评估该方法治疗急性移位舟骨骨折的可行性,并探索其适应证。

方法

2012年2月至2014年3月,15例急性移位舟骨骨折患者接受了我们的技术治疗。在传统经皮螺钉固定的整个过程中,使用两根克氏针实现并维持舟骨骨折的复位。记录以下参数,包括根据改良Mayo腕关节评分系统的功能评分、腕关节活动范围(ROM)、握力、捏力、愈合时间、恢复工作时间和最终结果。

结果

所有患者平均随访2.5年(范围2 - 3.5年)。所有骨折平均9.3周(范围7 - 11.5周)愈合。所有患者在六周内恢复到受伤前的活动水平。功能评分平均为90.3(范围80 - 100)。术后三个月腕关节ROM与对侧相等。与对侧相比,握力和捏力分别为98%和92%。所有患者对最终结果均满意。

结论

我们的技术成功应用于急性移位舟骨骨折,导致固定时间缩短和功能迅速恢复。它拓宽了经皮方法的适应证,意味着在最大程度保留经皮方法优点的同时避免了切开复位的缺点。

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