Xu Yujian, Xu Yongqing, He Xiaoqing, Li Chuan, Yang Xi, Zhang Xulin, Zhao Wanqiu
The Graduate School, Army Military Medical University, Chongqing, 400000, P.R.China.
Department of Orthopaedics, the 920th Hospital of Joint Logistics Support Force of Chinese PLA, Kunming Yunnan, 650032, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Jun 15;34(6):671-675. doi: 10.7507/1002-1892.201911013.
To evaluate the effectiveness of nitinol memory alloy two foot fixator combined with Kirschner wire in the treatment of trans-scaphoid perilunate dislocation.
Between September 2011 and October 2018, 17 patients with trans-scaphoid perilunate dislocation were treated with nitinol memory alloy two foot fixator and Kirschner wire. There were 12 males and 5 females, with an average age of 32.6 years (range, 23-52 years). The disease duration was 8 hours to 9 days, with an average of 6.5 days. The causes of injury included 6 cases of falling injury, 4 cases of traffic accident injury, 3 cases of stress injury of wrist caused by sports, 2 cases of violent injury of wrist caused by machine impact, 1 case of military training injury, and 1 case of other injury. One case was complicated with nerve injury. According to Herbert's classification, all the fractures were type B4. At 1 week before operation, 3 months, 6 months after operation and last follow-up, the wrist function was evaluated according to the Krimmer scale score.
All the 17 patients were followed up 10.5-48 months, with an average of 18.6 months. There was no loosening or infection of the internal fixator, no necrosis of the scaphoid and lunate. The periosteal dislocations of the patients were well reduced and the scaphoid fractures all healed. The healing time was 4-18 months, with an average of 11.3 months. The Krimmer wrist scores were 37.5±4.4, 61.3±7.2, 83.3±9.3, 87.3±8.2 at 1 week before operation, 3 months, 6 months after operation and last follow-up, respectively. The Krimmer wrist score at each time point after operation was significantly improved when compared with that before operation ( <0.05), and at 6 months after operation and last follow-up than at 3 months after operation ( <0.05). There was no significant difference between at 6 months and last follow-up ( >0.05). At last follow-up, the Krimmer wrist function was excellent in 13 cases, good in 2 cases, fair in 1 case, poor in 1 case, and the excellent and good rate was 88.23%.
Nitinol memory alloy two foot fixator combined with Kirschner wire in the treatment of trans-scaphoid periosteal dislocation has definite effectiveness, simple operation, and good recovery of wrist function after operation.
评估镍钛记忆合金双足固定器联合克氏针治疗经舟骨月骨周围脱位的疗效。
2011年9月至2018年10月，对17例经舟骨月骨周围脱位患者采用镍钛记忆合金双足固定器联合克氏针治疗。其中男性12例，女性5例，平均年龄32.6岁（范围23 - 52岁）。病程8小时至9天，平均6.5天。致伤原因包括：摔伤6例，交通事故伤4例，运动致腕部应力伤3例，机器撞击致腕部暴力伤2例，军训伤1例，其他伤1例。1例合并神经损伤。根据Herbert分型，所有骨折均为B4型。于术前1周、术后3个月、6个月及末次随访时，依据Krimmer评分标准评估腕关节功能。
17例患者均获随访，随访时间10.5 - 48个月，平均18.6个月。内固定物无松动、感染，舟骨及月骨无坏死。患者月骨周围脱位均复位良好，舟骨骨折均愈合。愈合时间4 - 18个月，平均11.3个月。术前1周、术后3个月、6个月及末次随访时Krimmer腕关节评分分别为37.5±4.4、61.3±7.2、83.3±9.3、87.3±8.2。术后各时间点Krimmer腕关节评分与术前比较差异有统计学意义（<0.05），术后6个月及末次随访时与术后3个月比较差异有统计学意义（<0.05）。术后6个月与末次随访时比较差异无统计学意义（>0.05）。末次随访时，Krimmer腕关节功能评定：优13例，良2例，可1例，差1例，优良率为88.23%。
镍钛记忆合金双足固定器联合克氏针治疗经舟骨月骨周围脱位疗效确切，操作简便，术后腕关节功能恢复良好。
