带血管筋膜蒂桡骨茎突骨瓣加Herbert螺钉内固定治疗陈旧性腕舟骨骨折  

Treatment of old scaphoid fracture with radial styloid bone flap pedicled with vascular fascia and Herbert screw internal fixation

作　　者：胡阿威[1] 夏训良[1] 夏春明[1] 何振华[1] 汪平[1] 徐明[1] 刘胜[1] 

机构地区：[1]武警湖北省总队医院骨二科,湖北武汉430061

出　　处：《临床骨科杂志》2017年第3期329-331,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨带血管筋膜蒂桡骨茎突骨瓣加Herbert螺钉内固定治疗陈旧性腕舟骨骨折的临床疗效。方法将40例陈旧性腕舟骨骨折患者按治疗方法不同分为自体骨移植加Herbert螺钉内固定组(A组,20例)和带血管筋膜蒂桡骨茎突骨瓣加Herbert螺钉内固定组(B组,20例),比较两组手术时间、骨折愈合时间、术后6个月腕关节功能Krimmer评分。结果患者均获得随访,时间6个月~2年。手术时间:A组为(52.3±9.4)min,短于B组的(88.5±9.5)min,差异有统计学意义(P<0.05)。骨折愈合时间:A组为(17.3±2.2)周,长于B组的(12.4±2.3)周,差异有统计学意义(P<0.05)。术后6个月腕关节功能Krimmer评分:A组为(83.5±7.4)分,低于B组的(96.8±7.5)分,差异有统计学意义(P<0.05)。结论带血管筋膜蒂桡骨茎突骨瓣加Herbert螺钉内固定术操作简便、创伤小、疗效满意,是治疗陈旧性腕舟骨骨折的有效方法。Objective To explore the clinical efficacy of treatment of old scaphoid fracture with radial styloid bone flap pedicled with vascular fascia and Herbert screw internal fixation.Methods There were 40 patients of old scaphoid fractures.They were divided into autogenous bone graft and Herbert screw internal fixation group （group A） and radial styloid bone flap pedicled with vascular fascia and Herbert screw internal fixation group （group B）.Twenty patients each group,the clinical effect was evaluated by comparing in operation time,fracture healing time and the wrist function Krimmer score of 6 months after surgery between two groups.Results All patients were followed up for 6~24 months.The operation time was （52.3±9.4） min in group A and （88.5±9.5） min in group B,group A was shorter than group B （P〈0.05）.The fractures healing time was （17.3±2.2） weeks in group A and （12.4±2.3） weeks in group B,group B was shorter than group A （P〈0.05）.The wrist function Krimmer score of six months after surgery was （83.5±7.4） points in group A and （96.8±7.5） points in group B,group B was better than group A （P〈0.05）.Conclusions It is an effective method for the treatment of old scaphoid fractures with simple operation,less trauma and satisfactory efficacy for radial styloid bone flap pedicled with vascular fascia and Herbert screw internal fixation.

关 键 词：腕舟骨骨折 血管筋膜蒂 桡骨茎突骨瓣 HERBERT螺钉 

分 类 号：R683.4[医药卫生—骨科学] R687.3[医药卫生—外科学]