早期切开复位无头加压空心螺钉及克氏针治疗经舟骨月骨周围脱位  

Early Open Reduction and Internal Fixation with Acephalous Compression Screws and Kirschner Wires for Trans-scaphoid Perilunar Dislocation

作　　者：张丽君[1] 魏登科[1] 王欣文 黄磊[1] 

机构地区：[1]陕西省西安市红十字会医院手外科,西安710054

出　　处：《中国现代手术学杂志》2011年第4期276-278,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨早期切开复位无头加压空心螺钉及克氏针内固定治疗经舟骨月骨周围脱位的临床疗效。方法 17例经舟骨月骨周围脱位患者,均行早期切开复位,克氏针固定月骨和头状骨,无头加压空心螺钉对舟骨骨折端进行加压固定,同时修复关节囊和韧带。结果 17例均获随访,平均10(3～12)个月,腕关节活动范围在106°～128°之间。X线片示舟骨完全愈合,腕关节轴线恢复好。根据Cooney评定标准,本组优11例,良4例,中2例,优良率88.2%。结论无头加压空心螺钉及克氏针内固定能达到舟骨解剖复位,恢复腕关节轴线,术后腕关节功能恢复较好,是治疗经舟骨月骨脱位的有效方法。Objective To evaluate the clinical effect of early open reduction and internal fixation with acephalous compression screws and Kirschner wires for trans-scaphoid perilunar dislocation. Methods The clinic data of seventeen patients with trans-scaphoid perilunar dislocation were analyzed retrospectively. All the patients were treated by open reduction and internal fixation with acephalous compression screws and Kirschner wires. The scaphoid was fixed by acephalous compression screws after reduced;and a Kirschner wire was placed from the capitate into the lunate to maintain reduction. Articular capsule and ligament were also repaired during the operation. Results All the seventeen cases were followed up for 3 to 12 months with an average of 10 months. After 12 months, the mean articular range of extension-flexion motion of the injured wrist was between 106° to 128°. X-ray exam showed that scaphoid fractures were completely healed and the axis of the wrist was almost normal. According to Cooney standardization of wrist function, the outcomes revealed that excellence in 11 cases, good in 4 cases, fair in 2 cases, and the fineness rate was 88.2%. Conclusion The internal fixation of acephalous compression screws and Kirschner wires can achieve anatomical reduction of the scaphoid and restore the axis of the wrist, and it is an effective method for fresh trans-scaphoid perilunar dislocation.

关 键 词：腕骨骨折 脱位 骨钉 内固定器 

分 类 号：R687.3[医药卫生—骨科学]