Hove L M
Bergen Accident and Emergency Department, Bergen Legevakt, Norway.
J Hand Surg Br. 1994 Jun;19(3):384-8. doi: 10.1016/0266-7681(94)90095-7.
Simultaneous fractures of the distal radius and scaphoid are uncommon. In a prospective 3-year study we registered 2,330 distal radial fractures and 390 scaphoid fractures, and 12 were combined. Ten of these had high energy trauma; six were styloid fractures, four Colles' fractures, one was a greenstick fracture and one Salter-Harris Type 2 epiphyseal fracture. All but one of the 12 scaphoid fractures were stable and healed without problems, and one was a trans-scaphoid, trans-styloid peri-lunate fracture-dislocation. The study supports the opinion that the distal radial fracture constitutes the principal injury that determines the outcome and hence the treatment. If the scaphoid fracture is unstable or dislocated, we recommend internal fixation of the scaphoid. Only a small proportion of these injuries represent a more serious disruption with carpal instability.
桡骨远端和舟状骨同时骨折并不常见。在一项为期3年的前瞻性研究中，我们记录了2330例桡骨远端骨折和390例舟状骨骨折，其中12例为合并骨折。这些合并骨折中有10例是高能量创伤；6例为茎突骨折，4例为科雷氏骨折，1例为青枝骨折，1例为Salter-Harris Ⅱ型骨骺骨折。12例舟状骨骨折中除1例之外均为稳定骨折，愈合过程顺利，1例为经舟状骨、经茎突的月骨周围骨折脱位。该研究支持以下观点，即桡骨远端骨折是决定预后及治疗方式的主要损伤。如果舟状骨骨折不稳定或发生脱位，我们建议对舟状骨进行内固定。这些损伤中只有一小部分表示腕关节不稳定的更严重破坏。
