桡骨茎突切除植骨术联合内固定治疗腕舟骨陈旧性骨折  

Excision of Styloid Radial Combined with Screw Internal Fixation in Treating Old Scaphoid Fracture

作　　者：王庆伟[1] 王华松 王俊伟[1] 丰瑞兵 周奇煌 WANG Qing-wei WANG Hua-song WANG Jun-wei FENG Rui-bing ZHOU Qi-huang(Graduate School of Hubei University of Chinese Medicine , Wuhan Hubei 430070, Chin)

机构地区：[1]湖北中医药大学研究生院,湖北武汉430070 [2]解放军武汉总医院骨科

出　　处：《华南国防医学杂志》2016年第12期788-791,共4页Military Medical Journal of South China

摘　　要：目的探讨采用桡骨茎突切除植骨术联合无头加压螺钉内固定治疗腕舟骨陈旧性骨折不愈合的临床疗效。方法对采用桡骨茎突切除植骨术联合无头加压螺钉内固定治疗的32例腕舟骨陈旧性骨折不愈合病例资料进行回顾性分析,其中男29例,女3例;年龄18~42岁,平均25.2岁;右侧损伤25例,左侧7例;骨折按Herbert分型：D2型12例,D3型17例,D4型3例。结果本组患者获随访6~18个月,平均10个月,末次随访患者均获骨性愈合,愈合时间3~10个月,平均6.3个月;末次随访患者疼痛按视觉模拟评分（visual analogue scale,VAS）：0分29例,2分3例;患侧手握力平均为健侧的80.3%;按照改良Mayo法评价术后腕关节功能：优24例,良5例,可3例,优良率90.6%。结论采用桡骨茎突切除植骨术联合无头加压螺钉内固定可有效治疗腕舟骨陈旧性骨折,临床疗效良好。Objective To evaluate the clinical effect of radial styloid bone resection surgery with headless screw fixation for the treatment of old scaphoid fracture nonunion.Methods Thirty-two cases of old scaphoid nonunion patients treated by radial styloid bone resection surgery and headless screw fixation were retrospectively analyzed.There were 29 males and 3 females,age from18 to 42 years（mean,25.2 years）,the right injury was involved in 25 cases and left in 7cases,factures were evaluated by Herbert classification：type D2 12 cases,type D3 17 cases,type D4 3 cases.ResultsThe follow-up lasted for 6 to 18 months（average 10 months）,all cases showed healing time in 3 to 10 months（average,6.3 months）.At the last visit,the pain score was 0in29 cases and 2in3 cases according to visual analogue scale（VAS）.The hand strength averaged 80.3% of the contralateral hand.The wrist joints function was evaluated by the modified Mayo function criteria：excellent in24 cases,good in5 and fair in3,the good and excellent rate was 90.6%.ConclusionUsing radial styloid bone resection surgery with headless screw fixation can be effective treating the old scaphoid fracture,and can achieve good clinical results.

关 键 词：腕舟骨 陈旧性骨折 植骨 无头加压螺钉 内固定 

分 类 号：R681.7[医药卫生—骨科学]