经皮舟骨结节入路Herbert螺钉内固定治疗非移位性腕舟骨骨折  

Percutaneous scaphoid nodule internal fixation with Herbert screw for the treatment of nondisplaced scaphoid fracture

作　　者：明立功 明朝戈[2] 王自方[1] MING Ligong;MING Chaoge;WANG Zifang(Department of Orthopedic,Hua County New District Hospital,Hua County,Henan,456400,China)

机构地区：[1]河南省滑县新区医院骨伤科,河南滑县456400 [2]河南省滑县骨科医院手外科,河南滑县456485

出　　处：《实用手外科杂志》2018年第4期411-413,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨Herbert螺钉治疗腕舟骨骨折的临床效果。方法 2010年1月-2014年7月,采用Herbert螺钉微创治疗15例腕舟骨骨折。术中结节部小切口入路,采用克氏针闭合临时固定、导向针一次性穿入、Herbert螺钉内固定技术。结果 15例骨愈合时间为术后7.5～10周,平均8.5周。患者均获随访,随访时间8～22个月,平均12个月。14例术后患手握力恢复至健侧的87.4%(82%～94%),患侧腕关节屈伸活动度恢复至健侧的86.5%(84%～98%)。除1例患者体力劳动后自觉有轻度腕痛改变原工作外,余病例术后疼痛消失,均恢复原工作。所有患者腕掌侧舟骨结节小切口均Ⅰ期愈合,无感染等并发症发生。结论经皮腕掌侧舟骨结节入路Herbert螺钉内固定是一种微创、骨折愈合率高、并发症相对较少的舟骨骨折有效治疗方法,值得推广应用。Objective To discuss the clinical effect of Herbert screw fixation on the scaphoid fracture.Methods From Jan 2010 to Jul 2014,15 cases of scaphoid fracture were treated by minimally invasive Herbert screw fixation.During the operation,small incision approach to nodule was adopted,using Kwire temporal fixation technique,one-time penetration of guide needle,the fracture was fixed by Herbert screw.Results The osteal healing time of 15 cases was 7.5 to 10 weeks,with the average of 8.5 weeks.All cases were followed up for 8 to 22 months,with the average of 12 months.The grip strength of affected hand in 14 cases recovered to 87.4%(82%~94%)of the healthy one.The flexion and extention activity of the wrist recovered to 86.5%(84%~98%),except one patient had slight wrist pain after physical activity,the remaining cases eliminated pain and returned to work.All patients obtained the primary healing of the scaphoid nodule incision,without any infection or complications.Conclusion Percutaneous metacarpal carpal scaphoid nodule approach internal fixation with Herbert screw is a kind of minimaUy invasive and effective therapy for scaphoid fractures with the advantages of high osteal healing rate and less complications.

关 键 词：腕关节 舟骨骨折 内固定 治疗效果 

分 类 号：R687.3[医药卫生—骨科学]