DeGeorge Brent R, Shin Alexander Y
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Tech Hand Up Extrem Surg. 2019 Mar;23(1):6-9. doi: 10.1097/BTH.0000000000000213.
Scaphoid fractures typically occur in young, healthy males at the peak of their employment and productivity, and left untreated or inadequately treated will ultimately progress to nonunion and a "predictable" pattern of wrist arthritis and carpal collapse. Nonoperative treatment of these fractures requires prolonged cast immobilization, which can lead to wrist stiffness, loss of grip strength, muscle atrophy, and protracted loss of economic productivity. To prevent these devastating sequelae, percutaneous techniques for scaphoid fixation have been described and popularized; however, these techniques are technically demanding as optimal position of the compression screw is required to achieve bony union. The focus of this paper is to describe the indications, contraindications, and a series of reproducible, practical pearls to achieve ideal percutaneous scaphoid compression screw fixation of scaphoid waist and distal pole fractures.
舟骨骨折通常发生在正值工作和生产力高峰期的年轻健康男性身上，若不治疗或治疗不当，最终会发展为骨不连以及出现“可预测”的腕关节关节炎和腕骨塌陷模式。这些骨折的非手术治疗需要长时间的石膏固定，这可能导致腕关节僵硬、握力丧失、肌肉萎缩以及经济生产力的长期损失。为预防这些严重后果，已有人描述并推广了用于舟骨固定的经皮技术；然而，这些技术对技术要求很高，因为需要将加压螺钉置于最佳位置才能实现骨愈合。本文的重点是描述适应证、禁忌证以及一系列可重复的实用技巧，以实现舟骨腰部和远极骨折的理想经皮舟骨加压螺钉固定。
