钛质空心加压螺钉微创治疗急性腕舟骨骨折  

Minimally invasive treatment of acute scaphoid fracture with titanium hollow compression screw

作　　者：韩权 熊建[1,2] 王艳华[1] 党育[1] 张培训[1] 付中国[1] 张殿英[1] 王天兵[1,2] Han Quan;Xiong Jian;Wang Yanhua;Dang Yu;Zhang Peixun;Fu Zhongguo;Zhang Dianying;Wang Tianbing(Department of Trauma Orthopaedics,people's Hospital,Peking University,Beijing 100044;Trauma treatment Center,people's Hospital,Peking University,Beijing 100044)

机构地区：[1]北京大学人民医院创伤骨科,北京市100044 [2]北京大学人民医院创伤救治中心,北京市100044

出　　处：《中国组织工程研究》2019年第34期5413-5417,共5页Chinese Journal of Tissue Engineering Research

基　　金：985经费-教育部长江学者和创新团队发展计划(IRT 16R01);北京大学临床+X专项联合研究项目(PKU2017LCX05);北京市科技计划项目(D161100002816001);首都卫生发展科研专项项目(首发-2016-1-4081)~~

摘　　要：背景:手术治疗是急性腕舟骨骨折的主要治疗方式之一,但对于经皮钛质空心加压螺钉内固定治疗无移位或轻微移位腕舟骨骨折是否可靠仍存在较大争议。目的:回顾性分析闭合(复位)经皮钛制空心加压螺钉内固定微创修复腕舟骨骨折的疗效。方法:回顾2010年1月至2018年7月于北京大学人民医院创伤骨科手术治疗的腕舟骨骨折患者的病历资料,其中21例行闭合(复位)钛制空心加压螺钉内固定微创修复,获取术前X射线及CT检查明确分型,经3个月以上随访,并获得术后X射线检查明确骨折愈合情况,采用改良Mayo腕关节功能评分评估患者术后疗效。结果与结论:①患者21例腕舟骨骨折均顺利愈合,平均骨折愈合时间为(9.10±3.03)周;②患者恢复日常工作或学习的平均时间为(7.00±4.08)d;③根据改良Mayo腕关节功能评分,16例为优,4例为良,1例为一般,优良率95.2%;④Herbert分型B1型患者(n=6)较A2型(n=5)和B2型(n=10)患者术后Mayo疼痛程度评分降低(P<0.05),即Herbert分型B1型患者术后疼痛程度更重;⑤结果证实,经皮钛质空心加压螺钉内固定微创修复急性腕舟骨骨折疗效可靠。该研究方案已经北京大学人民医院伦理委员会讨论批准。.BACKGROUND:Surgery is one of the main methods for the treatment of acute scaphoid fracture.But it is still controversial whether percutaneous titanium hollow compression screw internal fixation is reliable for the treatment of non-displaced or slightly displaced scaphoid fractures.OBJECTIVE:To retrospectively analyze the efficacy of closed reduction and percutaneous hollow compression screw internal fixation in the treatment of scaphoid fractures.METHODS:Twenty-one patients with scaphoid fractures who received closed reduction and percutaneous hollow compression screw internal fixation surgery in the Department of Traumatology and Orthopedics,Peking University People’s Hospital,China between January 2010 and July 2018 were included in this study.All of them underwent preoperative X-ray and CT examination to make diagnosis and clarify classification.They were followed up for over 3 months.Postoperative X-ray examination was also performed to identify fracture healing.Modified Mayo wrist function score was used to evaluate postoperative efficacy.RESULTS AND CONCLUSION:Scaphoid fractures healed successfully in all patients,with an average healing time of(9.10±3.03)weeks.The average time for patients to resume daily work or study was(7.00±4.08)days.According to the modified Mayo clinic score,excellent healing was found in 16 patients,good healing in 4 patients,and fair healing in 1 patient,with the excellent and good rate of 95.2%.Patients with Herbert type B1(n=6)had lower postoperative Mayo pain score than those with A2(n=5)and B2(n=10)(P<0.05).This indicates that patients with B1 type had more postoperative pain.Results from this study suggest that closed reduction percutaneous titanium hollow compression screw internal fixation surgery is reliable in the treatment of acute scaphoid fracture.This study was approved by Medical Ethics Committee,Peking University People’s Hospital,China.

关 键 词：腕舟骨 骨折 急性 移位 微创 手术 空心加压螺钉 Herbert分型 Mayo评分 回顾性研究 

分 类 号：R459.9[医药卫生—治疗学] R605[医药卫生—临床医学]