Herbert螺钉微创治疗腕舟骨骨折  

The Treatment of Scaphoid Fracture with Herbart Screw

作　　者：陈超斌[1] 陈振兵[2] 王忠仁[1] 李志强[1] 

机构地区：[1]解放军457医院骨科,湖北武汉430012 [2]华中科技大学同济医学院附属协和医院手外科,湖北武汉430022

出　　处：《实用骨科杂志》2010年第2期90-92,共3页Journal of Practical Orthopaedics

摘　　要：目的总结利用Herbert螺钉及微创外科技术治疗腕舟骨骨折的临床应用。方法2006年2月至2009年2月,Herbert螺钉微创治疗18例腕舟骨骨折。术前斜矢状位CT确诊骨折及分型;术中结节部小切口入路,采用克氏针闭合间接撬拨复位技术、导向针一次性穿入技术、Herbert螺钉加压髓内固定技术;术后避免骨折不利活动,循序渐进功能锻炼。结果18例随访4～14个月,平均12个月;均骨性愈合,骨愈合时间7～10周,平均9周;CT示1例螺钉穿透皮质骨;1例轻度畸形愈合;1例术中骨折复位困难,行切开复位内固定;18例均无感染、骨不连、骨坏死、创伤性关节炎等并发症;按Krimmer腕关节功能总体疗效评分,优13例,良3例,满意1例,差1例,优良率为88.9%。结论应用Herbert螺钉及微创外科技术治疗腕舟骨骨折疗效满意,值得临床推广应用。Objective To investigate the treatment of scaphoid fracture with Herbart Screw of micro-trauma in clinic. Methods 18 patients of scaphoid fracture with Herbart Screw and grouping before operating by oblique-an- teroposterior axes CT. The small incision was used in operating via Kirschner wire turn reset and targeting wire pene- tration only once. After operation harmful activity was refrained and functional training gradually. Results Follow-up 4~14 moflths in 18 patients,average 12 months,all bone-healing,the healing time from 7 to 10 months,average 9 months. 1 break through the cortical bone, 1 little malformation, 1 reset too difficult to cut open in CT image. All have no complication including infection ,no-conection ,necrosis, osteoarthritis etc. 2 wrists feel little pain and activity handi- cap,grasp force well,according to Krimmer^s score method of total therapeutic effection： 13 excellent ,3 well, 1 satis- faction,88.9% good rate. Conclusion The treatment of scaphoid fracture with Herbart Screw can get firm fixation, miero2trauma,function training and healing early.

关 键 词：微创 舟骨骨折 HERBERT螺钉 治疗 

分 类 号：R683.41[医药卫生—骨科学]