Lucenti Ludovico, Lutsky Kevin F, Jones Christopher, Kazarian Erick, Fletcher Daniel, Beredjiklian Pedro K
Department of Orthopaedic Surgery, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Italy.
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
J Wrist Surg. 2020 Feb;9(1):34-38. doi: 10.1055/s-0039-1698745. Epub 2019 Oct 16.
Scaphoid waist fractures are often treated using headless compression screws using dorsal or volar approaches. The purpose of this study is to compare differences in screw position using a volar (retrograde) or dorsal (antegrade) approach. A total of 82 patients were retrospectively evaluated: 41 treated with a volar and 41 with a dorsal approach were selected. Postoperative radiographs were reviewed by three observers who rated screw location in the proximal pole, waist, and distal pole. Thirty-four patients (83%) in the antegrade group had central screw placement in the waist of the scaphoid in posteroanterior and lateral planes compared with 14 (34.9%) in the retrograde group ( < 0.05). For the antegrade group, the screw was central in 217 of 246 zones (88.2%) compared with 127 of 246 (51.6%) in the retrograde group ( < 0.05). The dorsal antegrade approach appears to allow the surgeon to achieve central screw placement along all three scaphoid regions. This is Level III study.
舟状骨腰部骨折通常采用无头加压螺钉经背侧或掌侧入路进行治疗。本研究的目的是比较经掌侧（逆行）或背侧（顺行）入路时螺钉位置的差异。共对82例患者进行了回顾性评估：选择41例采用掌侧入路治疗的患者和41例采用背侧入路治疗的患者。三位观察者对术后X线片进行了评估，他们对螺钉在近端极、腰部和远端极的位置进行了评分。顺行组34例患者（83%）在前后位和侧位片上螺钉位于舟状骨腰部中央，而逆行组为14例（34.9%）（P<0.05）。对于顺行组，246个区域中有217个区域（88.2%）螺钉位于中央，而逆行组246个区域中有127个区域（51.6%）螺钉位于中央（P<0.05）。背侧顺行入路似乎能使外科医生在舟状骨的所有三个区域实现螺钉的中央置入。这是一项三级研究。
