Department of Orthopedic, Faculty of Medicine, AL-Azhar University, Nasr City, Egypt.
Department of Orthopedic, Faculty of Medicine, Portsaid University, Portfouad, Egypt.
J Plast Surg Hand Surg. 2021 Jun;55(3):167-172. doi: 10.1080/2000656X.2020.1856674. Epub 2020 Dec 17.
We compared two methods of fixation for unstable scaphoid waist nonunions regarding rate of scaphoid union, union time, deformity correction, clinical outcomes (pain, range of motion, and grip strength), and QuickDASH scores. Eighty-nine patients who undergo cancellous iliac bone grafting and internal fixation either with a Herbert screw ( = 46) or multiple Kirschner wires ( = 43) were evaluated. The rate of scaphoid union in the K-wire group was 98% ( = 42) versus 89% ( = 41) in the screw group. The mean union time and duration of surgery for K-wire group versus screw group were 12 versus 15 weeks and 45 versus 66 min respectively. There was no significant difference between the two groups with respect to deformity correction, clinical outcomes, and QuickDASH scores. Despite there was no significant difference in the rate of scaphoid union between the two fixation methods, the K-wires procedure had the advantages of short union time, less demanding, and less expensive than the screw implant.
我们比较了两种不稳定的舟状骨腰部骨不连的固定方法，比较内容包括舟状骨愈合率、愈合时间、畸形矫正、临床结果（疼痛、活动度和握力）和 QuickDASH 评分。我们评估了 89 例接受松质髂骨移植和内固定的患者，分别采用 Herbert 螺钉（ = 46）或多根克氏针（ = 43）固定。在克氏针组，舟状骨愈合率为 98%（ = 42），而螺钉组为 89%（ = 41）。克氏针组的平均愈合时间和手术时间分别为 12 周和 45 分钟，而螺钉组分别为 15 周和 66 分钟。两组在畸形矫正、临床结果和 QuickDASH 评分方面无显著差异。尽管两种固定方法的舟状骨愈合率无显著差异，但克氏针手术具有愈合时间短、要求低、费用低等优点，优于螺钉植入。
