加压骑缝钉克氏针治疗经舟骨月骨周围骨折脱位  

Uniclip and K-wires for Trans-scaphoid Perilunate Fracture with Dislocation

作　　者：沈华[1] 蔡嬿娴[1] 王永春[1] 张兆峰[1] 沈尊理[1] 

机构地区：[1]上海交通大学医学院附属第一人民医院整形科,上海市200080

出　　处：《组织工程与重建外科杂志》2010年第1期35-37,共3页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨加压骑缝钉克氏针内固定治疗经舟骨月骨周围骨折脱位的临床疗效。方法2006年2月至2008年9月,我们采用加压骑缝钉克氏针内固定治疗11例经舟骨月骨周围骨折脱位患者,年龄18～39岁。术中采用克氏针固定月骨、头状骨,单夹骑缝钉固定舟骨,加压矫正分离移位,术中同时修复关节囊和韧带。术后8周拔除克氏针开始活动,6～12个月根据舟骨愈合情况取出骑缝钉,术后随访6～24个月。结果术后通过腕关节活动度、手握力、用力后腕关节疼痛程度、X线片和CT检查评价治疗效果,患者术后腕关节活动及手握力良好。影像学检查舟骨骨折均骨性愈合,骨折愈合时间4-10月。结论加压骑缝钉克氏针内固定治疗经舟骨月骨周围骨折脱位,直视切口手术,操作简便可靠,可同时修复韧带,并可减少术后并发症,是目前较好的治疗手段之一。Objective To evaluate the role of uniclip and K-wires in the management of trans-scaphoid perilunate fracture with dislocation. Methods From February 2006 to September 2008, a retrospective study was done in 11 patients of trans-scaphoid perilunate fracture with dislocation. All patients were treated with uniclip and K-wires, aging 18 to 39 years. Scaphoid was fixed by an uniclip with pressure after dislocation were reduced; and a k-wire was placed from the capitate into the lunate to maintain reduction. Articular capsule and ligament were also repaired during the operation. Wrist joint began to activate at 8 weeks postoperatively following the k-wire was took away. The X-ray films showed that the scaphoid bony began to fuse and the uniclip was removed. All the 11 patients were followed up for 6-24 months. Results Curative effects were assessed by Wrist examination including wrist range of motion, grip strength, pain, X-ray views or computer tothography. The scaphoid fracture healed in all cases 4-10 months after operation. The range of movement of the wrist and grip strength was good. Conclusion Open reduction and internal fixation with uniclip and K-wires obtained satisfactory results in terms of anatomical restoration, the repair of articular capsule and ligament. It has superiority over other methods with more stability, direct viewing and less complications.

关 键 词：腕关节 骨折 舟骨 月骨周围脱位 克氏针 骑缝钉 

分 类 号：R683.41[医药卫生—骨科学]