摘要
目的 评价早期手术治疗经舟骨月骨周围骨折脱位的临床疗效.方法 15例经舟骨月骨周围骨折脱位的患者,采用切开复位加压螺钉和克氏针内固定.术后评估腕部疼痛、腕关节活动度、手部握力及骨折愈合,并用腕关节Krimmer评分法评估疗效.结果 13例获得6～12个月随访,平均9个月.2例出现静息痛,3例活动时疼痛.腕关节屈伸活动度（65±11）°,尺桡偏角度为（10±8）°,平均握力较健侧减少10%.X片检查3例腕关节炎,2例舟骨骨折近端骨质吸收致舟骨不愈合.11例腕舟骨愈合,平均愈合时间为4.8个月.Krimmer评分法评估总体疗效：优7例,良1例,可3例,差2例.结论 早期切开复位应用克氏针和加压螺钉同时内固定治疗经舟骨月骨周围骨折脱住手术方式可行、疗效可靠.
Objective To research early open reduction and internal fixation （ORIF） for the treatment of transscaphoid perilunate dislocation. Methods In this series, 15 patients （15 wrists） with transscaphoid perilunate dislocation underwent ORIF by using Herbert screw and Kirschner wires. After surgery, the patient was assessed for wrist pain, wrist range of motion, hand grip strength, bone union, and Krimmer wrist score. Results In this series, 13 patients were returned for follow-up. At the final follow-up （mean, 9 months; range, 6 to 12 months）, 2 patients reported wrist pain at rest, and 3 reported pain with movement. The wrist flexion-extension and radial-ulnar deviation arcs were measured to be （65_＋11） ~and （10_＋8） o, respectively. The mean grip strength of the injury sides reached 90% of the normal contralateral sides. Radiography showed arthritis in 3 wrists and fracture nonunion in 2. There were excellent in 7, good in 1, fair in 3, and poor in 2 results, according to Krimmer wrist score. Conclusion Based on our study, early OR.IF is reliable for the treatment of transscaphoid perilunate dislocation.
出处
《实用手外科杂志》
2011年第1期15-16,共2页
Journal of Practical Hand Surgery
关键词
骨折
脱位
舟骨
内固定
Fracture
Dislocation
Scaphoid
Internal fixation
