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[采用无头空心螺钉及桡骨远端松质骨自体移植治疗舟骨骨折不愈合]

[Treatment for non-union scaphoid fractures with headless cannulated screws and distal radius cancellous autograft].

作者信息

Santiago-Balmaseda E, Sánchez-Rowold R, Romo-Rodríguez R

机构信息

Centro Médico ABC. Ciudad de México. México.

出版信息

Acta Ortop Mex. 2022 Sep-Oct;36(5):268-273.

Abstract

INTRODUCTION

scaphoid fractures comprise 50-80% of the fractures of the carpal bones. Ten percent of the scaphoid fractures evolve to non-union and show degenerative changes in the carpus in 75-97% at five years and in 100% at 10 years. The objective of this work was to evaluate the rate and time to union in patients with diagnosis of scaphoid non-union without fragmentation of the proximal pole after treatment with two cannulated headless screws and distal radius cancellous autograft.

MATERIAL AND METHODS

case series with short-term follow-up of four patients with scaphoid non-union without fragmentation of the proximal pole treated by internal fixation using two cannulated headless screws and distal radius cancellous bone autograft. All received the same postoperative treatment and radiographic control was taken as soon as the patient experienced clinical resolution.

RESULTS

the radiographic union rate was 100% with an average time to union of 11.25 ± 3.4 weeks. There were no complications and revision surgery was not necessary.

CONCLUSION

the results of the use of two cannulated headless screws and distal radius cancellous bone autograft endorses the technique as an effective and safe option for the treatment of scaphoid non-union without fragmentation of the proximal pole.

摘要

引言

舟骨骨折占腕骨骨折的50%-80%。10%的舟骨骨折会发展为骨不连,5年后75%-97%的患者腕骨出现退行性改变,10年后则100%出现。本研究的目的是评估采用两枚空心无头螺钉及桡骨远端松质骨自体移植治疗诊断为舟骨骨不连且近端极无碎裂的患者的骨愈合率及愈合时间。

材料与方法

对4例近端极无碎裂的舟骨骨不连患者采用两枚空心无头螺钉及桡骨远端松质骨自体移植进行内固定治疗,并进行短期随访的病例系列研究。所有患者接受相同的术后治疗,一旦患者临床症状缓解即进行影像学检查。

结果

影像学骨愈合率为100%,平均愈合时间为11.25±3.4周。无并发症发生,无需翻修手术。

结论

使用两枚空心无头螺钉及桡骨远端松质骨自体移植的结果支持该技术作为治疗近端极无碎裂的舟骨骨不连的一种有效且安全的选择。

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