经皮腕掌侧入路Herbert螺钉内固定治疗非移位性舟骨骨折  

Percutaneous fixation for the treatment of un-displaced scaphoid fractures with Herbert cannulated screws through volar approach

作　　者：毛海蛟[1] 刘振新[1] 

机构地区：[1]宁波大学医学院附属医院创伤骨科,浙江宁波315020

出　　处：《中国骨伤》2014年第3期187-190,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的：总结经皮腕掌侧入路Herbert螺钉内固定治疗舟骨骨折的经验。方法：自2008年4月至2012年9月，采用经皮腕掌侧入路Herbert螺钉内固定治疗舟骨骨折15例，男14例，女1例；年龄25～45岁，平均35岁；左侧10例，右侧5例。患者自受伤至就诊时间3～10 d，平均5 d。术前均行常规X线及CT检查，所有舟骨骨折提示均为B2型骨折（Herbert分型）。根据腕关节功能Krimmer评分标准对所有患者术后腕关节功能恢复情况进行评价。结果：15例患者获随访，时间5～18个月，平均10个月。术后3个月内每月复查X线1次，骨折愈合时间7～14周，平均10周，螺钉位置良好。术后参考Krimmer评分标准进行腕关节功能评定，14例为100分，1例90分。所有患者腕掌小切口Ⅰ期愈合，无感染和骨不愈合等并发症发生。结论：经皮腕掌侧入路Herbert螺钉内固定治疗舟骨骨折是一种微创、骨折愈合率高、并发症相对较少的有效治疗方法。Objective：To summarize the experience of percutaneous fixation of scaphoid fractures with Herbert screws through volar approach,and provide a reliable and efficient treatment method for scaphoid fractures. Methods：From April 2008 to September 2012,15 patients with scaphoid fractures were treated by percutaneous fixation with Herbert cannulated screws through volar approach including 14 males and 1 female with an average age of 35 years ranging from 25 to 45 years old. Among them,10 cases were on left side and 5 cases were on right side. Durations from injury to operation ranged from 3 to 10 days with an average of 5 days. All these cases were identified as B2 type according to the Herbert classification based on X ray and CT scan. In order to assess the function of wrist ,all patients were calculated according to Krimmer＇s score postoperatively. Results：The follow up period were from 5 to 18 months with an average of 10 months. At 3 months after operation ,X ray was re checked every month. All the patients achieved bone union with a mean time of 10 weeks （ranged from 7 to 14 weeks） post-operatively. According to Krimmer＇s score ,14 cases gained 100 scores as perfect and one case got 90 scores as good. The small volar incision of all patients were union at the first period. No operation complications such as infection and nonunion occurred. Conclusion：Percutaneous fixation with Herbert cannulated screws through volar approach is a reliable and efficient treatment method for scaphoid fractures with small invasion,high bone union rate,and fewer complications.

关 键 词：舟骨 骨折 骨折固定术 内 

分 类 号：R683.41[医药卫生—骨科学]