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舟头状骨骨折。结合一例病例并复习文献

[Scapho-capitate fracture. Apropos of a case, review of the literature].

作者信息

Boisgard S, Bremont J L, Guyonnet G, Chatenet T, Levai J P

机构信息

Service Orthopédie, Traumatologie, chirurgie plastique et reconstructive I, Hôpital G. Montpied, CHU de Clermont-Ferrand.

出版信息

Ann Chir Main Memb Super. 1996;15(3):181-8. doi: 10.1016/s0753-9053(96)80007-x.

Abstract

Scapho-capitate fracture is a rare lesion. Its mechanism is controversial. Forced extension seems to be the most frequent etiology, as this movement of the wrist induces scaphoid fracture by compression. Hyperextension of the wrist, as a result of the scaphoid lesion, allows contact between the posterior margin of the radius and the neck of the capitatum, inducing capitatum fracture. Continuation of the movement allows a two-stroke rotation of the capitate proximal pole. Analysis of a personal case and review of the literature demonstrated: the frequency of extension movement for etiology, delayed diagnosis, and the need for surgery. Surgery should be performed early with capitate reduction and osteosynthesis in case of instability, scaphoid reduction and minimal osteosynthesis a graft may be necessary. Immobilisation of the carpus and the thumb is essential until bone consolidation. Early surgery should avoid complications such as necrosis or pseudarthrosis.

摘要

舟月骨骨折是一种罕见的损伤。其机制存在争议。强迫伸展似乎是最常见的病因,因为手腕的这种运动会因挤压导致舟骨骨折。由于舟骨损伤导致的手腕过度伸展,会使桡骨后缘与头状骨颈部接触,从而引发头状骨骨折。该动作的持续会使头状骨近端两极出现双程旋转。对一例个人病例的分析及文献回顾表明:伸展动作作为病因的频率、诊断延迟以及手术的必要性。若出现不稳定情况,应尽早进行手术,对头状骨进行复位及骨固定,对舟骨进行复位及最小化骨固定,可能还需要植骨。在骨愈合之前,固定腕关节和拇指至关重要。早期手术应避免坏死或假关节等并发症。

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