Towfigh H
Handchirurgie. 1981;13(3-4):242-6.
Fractures and luxations in the area of the carpal bones are in comparison with other fractures of the upper and lower extremities comparatively rare. Isolated fractures of luxations of the distal row of the carpal bones, by comparison with those of the proximal row, are still rarer incidents. Because of tight ligamentous unions between the carpal bones on the one hand and between the distal row of the carpal and the metacarpal bones on the other hand, a luxation or fracture is connected with a violent contusion or sprain. In the case of seriously or multiply injured persons the carpal injuries might be failed to be noticed. This may also occur in the case of insufficient auxiliary diagnostic measures. Crush-fractures as well as irreducible luxations should be immobilized by combination of adaptation-osteosynthesis and external fixation. An example is presented of an isolated fracture-dislocation of the trapezium after violent multiple trauma, with healing of the trapezium by adaptation-osteosynthesis and plaster immobilisatioi. The function was recovered after 10 weeks.
与上肢和下肢的其他骨折相比,腕骨区域的骨折和脱位相对少见。与近排腕骨的骨折或脱位相比,远排腕骨的孤立性骨折或脱位更是罕见。一方面,由于腕骨之间以及另一方面远排腕骨与掌骨之间存在紧密的韧带连接,脱位或骨折常伴有严重的挫伤或扭伤。在重伤或多处受伤的患者中,腕部损伤可能未被注意到。这在辅助诊断措施不足的情况下也可能发生。对于粉碎性骨折以及不可复位的脱位,应采用适应性骨合成与外固定相结合的方法进行固定。文中给出了一个因严重多发伤导致的大多角骨孤立性骨折脱位的病例,通过适应性骨合成和石膏固定,大多角骨实现愈合。10周后功能恢复。