Unit of Hand Surgery, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, Largo A. Gemelli 8, 00168, Rome, Italy.
Eur J Orthop Surg Traumatol. 2024 Dec;34(8):4001-4008. doi: 10.1007/s00590-024-04095-2. Epub 2024 Sep 20.
The primary method employed worldwide for the treatment of scaphoid fractures is screw fixation. However, in unstable and comminuted fractures, percutaneous fixation could produce complications due to technical challenges, such as improper axis positioning, inaccurate screw length measurement, intra-articular screw penetration, and impingement. Alternative open approaches for the surgical management of scaphoid fractures have been proposed, and in recent years, a new specific volar locking plate for the treatment of scaphoid fractures has been developed. This study aims to present the outcomes of this technique applied to 44 patients with unstable and comminuted fractures of the scaphoid.
The purpose of the study is to verify the effectiveness of the volar plate in the treatment of comminuted scaphoid fractures and the necessity for plate removal when consolidation has occurred.
Between January 2021 and March 2023, a specific volar locking plate for the treatment of scaphoid fractures was used in 44 patients. A retrospective study was conducted involving all patients, consisting of continuous clinical and radiographic assessments, functional evaluations (using QuickDASH and MHQ), and patient satisfaction surveys.
All patients achieved clinical and radiographic recovery. However, the plate can impinge with nearby structures and should be removed once the fracture is consolidated. After plate removal, further improvement in range of motion was observed.
The plate and screws system is a viable and appropriate method of osteosynthesis in the treatment of unstable and comminuted recent fractures occurring in the middle third of the carpal scaphoid.
全球范围内治疗舟状骨骨折的主要方法是螺钉固定。然而，在不稳定和粉碎性骨折中，经皮固定由于技术挑战，如不当的轴线定位、不准确的螺钉长度测量、关节内螺钉穿透和撞击，可能会产生并发症。已经提出了替代的开放方法来处理舟状骨骨折，近年来，一种新的专门用于治疗舟状骨骨折的掌侧锁定板已经开发出来。本研究旨在介绍该技术应用于 44 例不稳定和粉碎性舟状骨骨折患者的结果。
本研究旨在验证掌侧钢板治疗粉碎性舟状骨骨折的有效性，以及在骨折愈合时是否需要取出钢板。
2021 年 1 月至 2023 年 3 月，采用专门用于治疗舟状骨骨折的掌侧锁定板治疗 44 例患者。对所有患者进行了回顾性研究，包括连续的临床和影像学评估、功能评估（使用 QuickDASH 和 MHQ）和患者满意度调查。
所有患者均获得临床和影像学恢复。然而，当骨折愈合后，钢板可能会与附近的结构产生撞击，应将其取出。取出钢板后，观察到活动度进一步改善。
在治疗发生在舟状骨中段的不稳定和粉碎性近期骨折时，钢板和螺钉系统是一种可行且合适的骨合成方法。
