Severo Antônio Lourenço, Cattani Rodrigo, Schmid Filipe Nogueira, Cavalheiro Haiana Lopes, Castro Neto Deodato Narciso de, Lemos Marcelo Barreto de
Instituto de Ortopedia e Traumatologia, Hospital São Vicente de Paulo (HSVP), Universidade Federal da Fronteira Sul (UFFS), Passo Fundo, RS, Brazil.
Rev Bras Ortop. 2018 Apr 1;53(3):267-275. doi: 10.1016/j.rboe.2018.03.004. eCollection 2018 May-Jun.
Analyze the percutaneous fixation technique for scaphoid fractures in the waist of the scaphoid and the proximal pole, and demonstrate its result.
A retrospective cross-cohort study conducted from January 2005 to April 2015, aiming at the consolidation time, epidemiological profile, level of function, return to work, and complications.
Twenty-eight patients were selected, with a mean of eight weeks of follow-up. They presented a mean age of 30.5 years, male prevalence (25 patients; 89.2%), and no differences between dominant and non-dominant sides. The mean time from diagnosis was 4.16 weeks, but in three cases of fibrous union, the pre-operative period was over one year. The most frequent mechanism of injury was a fall on the outstretched hand, in 22 cases (78.5%). Of all fractures, 24 cases were in the waist (85.8%) and four were of the proximal pole (14.2%); seven patients had displacement (25%). There was consolidation in 26 cases (92.8%) with a mean of 7.5 weeks after surgery. In cases of non-union, radiological follow-up was up to 24 weeks, requiring a new surgical intervention.
Percutaneous fixation is an excellent, reproducible technique that allows early active mobility of the wrist with a low complication rate, although it requires a learning curve.
分析舟状骨腰部和近端极部骨折的经皮固定技术，并展示其效果。
进行一项回顾性交叉队列研究，时间跨度为2005年1月至2015年4月，旨在研究骨折愈合时间、流行病学特征、功能水平、重返工作情况及并发症。
选取28例患者，平均随访8周。患者平均年龄30.5岁，男性居多（25例；89.2%），优势侧与非优势侧无差异。从诊断到治疗的平均时间为4.16周，但在3例纤维性骨愈合病例中，术前时间超过1年。最常见的损伤机制是伸展手部着地摔倒，共22例（78.5%）。所有骨折中，24例位于腰部（85.8%），4例位于近端极部（14.2%）；7例患者存在移位（25%）。26例（92.8%）实现骨折愈合，术后平均7.5周。对于骨不连病例，影像学随访长达24周，需要再次进行手术干预。
经皮固定是一种出色的、可重复的技术，能使腕关节早期进行主动活动，并发症发生率低，不过需要一个学习过程。
