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克氏针内固定在舟骨骨折中与刚性螺钉固定效果相当:长期功能结果

Internal fixation with Kirschner wires is as efficient as rigid screw fixation in scaphoid fracture: long-term functional outcome.

作者信息

Jiang Ziping, Cui Jianli, Gong Xu, Lu Laijin

出版信息

Acta Orthop Belg. 2018 Mar;84(1):99-104.

Abstract

This study aimed to compare the long-term efficacy of Kirschner wires and Herbert screw internal fixation in scaphoid fracture. A retrospective chart with radiographic review and functional follow-up was conducted for patients with the scaphoid fracture. 65 patients (40 for K-wire fixation and 25 for Herbert screw) were enrolled. The nonunion rate for K-wire fixation and screw method were indifferent comprehensively and for iliac graft subgroup. Less bone necrosis was found with K-wire fixation (2.5% vs 16%, P=0.049). There's no difference between groups in Mayo scores, post-operation pain and grid strength. Patients with K-wire fixation have larger range of motion on radial/ulnar deviation (35.25±11.32 vs 28.00±8.66, P=0.007). The results support the use of Kirschner wires in the treatment of scaphoid fractures. Advantages such as high union rates and good function recovery of wrist could be expected from minimal invasion, multi-axial stable fixation.

摘要

本研究旨在比较克氏针与Herbert螺钉内固定治疗舟骨骨折的长期疗效。对舟骨骨折患者进行了一项带有影像学复查和功能随访的回顾性图表研究。共纳入65例患者(40例行克氏针固定,25例行Herbert螺钉固定)。克氏针固定组与螺钉固定组总体及髂骨移植亚组的骨不连发生率无差异。克氏针固定组的骨坏死较少(2.5%对16%,P=0.049)。两组在Mayo评分、术后疼痛和握力方面无差异。克氏针固定患者在桡偏/尺偏时的活动范围更大(35.25±11.32对28.00±8.66,P=0.007)。结果支持使用克氏针治疗舟骨骨折。通过微创、多轴稳定固定有望获得高愈合率和良好的腕关节功能恢复等优势。

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