Vécsei V, Scharf W
Arch Orthop Trauma Surg (1978). 1980;97(2):151-6. doi: 10.1007/BF00450938.
The results of 193 conservatively treated acute fractures of the carpal navicular are presented. Ninety-eight (50.7%) had horizontal oblique fractures, 82 (42.5%) transverse, and 13 (6.8%) vertical oblique fractures. In 23 (11.9%) cases the fracture was located in the proximal third, in 125 (64.7%) in the middle third, and in 45 (23.4%) in the distal third. An unpadded cast extending from the elbow to the metacarpophalangeal joints including the thumb was used generally. On the following day the cast was always completed by addition of a volar plaster splint and a circular plaster bandage. Duration of immobilization lasted from 6 to 16 weeks (mean: 10 weeks). On average, 4.5 years after injury 190 (98.4%) fractures had healed by osseous union and 3 (1.6%) had a pseudarthrosis. The reasons for non-union were too short time of immobilization, and former diastasis between the fragments. The number of arthrosis in the radiocarpal joint in our patients amounted to less than 1%. Primary operative treatment (open reduction and screwing) is preferred for vertical oblique fractures and for fractures with a large diastasis between the fragments. Secondary operative treatment is performed if there are no signs of osseous consolidation.
本文呈现了193例经保守治疗的腕舟骨急性骨折的结果。其中98例（50.7%）为水平斜形骨折，82例（42.5%）为横行骨折，13例（6.8%）为垂直斜形骨折。骨折位于近端三分之一处的有23例（11.9%），位于中间三分之一处的有125例（64.7%），位于远端三分之一处的有45例（23.4%）。一般使用从肘部延伸至掌指关节（包括拇指）的无衬垫石膏。次日，总是通过添加掌侧石膏夹板和环形石膏绷带完成石膏固定。固定时间持续6至16周（平均：10周）。受伤后平均4.5年，190例（98.4%）骨折通过骨愈合，3例（1.6%）出现假关节。骨折不愈合的原因是固定时间过短以及骨折碎片先前存在分离。我们患者的桡腕关节骨关节炎发生率不到1%。对于垂直斜形骨折以及骨折碎片间有较大分离的骨折，首选一期手术治疗（切开复位并拧入螺钉）。如果没有骨愈合迹象，则进行二期手术治疗。
