多方向立体固定并髓内植骨治疗手舟骨骨折不愈合  

Multi-directional stereoscopic fixation combined with intramedullary bone grafting for the treatment of nonunion of scaphoid fractures

作　　者：郭绍勇 于洋 刘铁虎 周瑞华 黄素萍 赵祚塨 任我行 GUO Shao-yong;YU Yang;LIU Tie-hu;ZHOU Rui-hua;HUANG Su-ping;ZHAO Zuo-gong;REN Wo-xing(SectionⅢ,Dept of Hand Surgery,Luoyang Orthopedic-Traumatological Hospital of Henan Province,Henan Provincial Orthopedic Hospital,Luoyang,Henan 471000,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)手外三科,河南洛阳471000 [2]河南推拿职业学院中职教学部,河南洛阳471023 [3]河南中医药大学第二临床医学院,河南郑州450046

出　　处：《临床骨科杂志》2023年第2期222-225,共4页Journal of Clinical Orthopaedics

摘　　要：目的 探讨多方向立体固定并髓内植骨治疗手舟骨骨折不愈合的临床疗效。方法 采用多方向立体固定并髓内植骨治疗20例手舟骨骨折不愈合患者。记录术中出血量、手术时间、骨折愈合情况及并发症发生情况,采用改良Mayo腕关节评分标准评定疗效。结果 术中出血量15~60 ml,手术时间42~83 min。患者均获得随访,时间9~24个月。无感染、内固定断裂等并发症发生。骨折均骨性愈合,时间3~15个月。末次随访时采用改良Mayo腕关节评分标准评定疗效:优15例,良3例,可2例,优良率18/20。结论 采用多方向立体固定并髓内植骨治疗手舟骨骨折不愈合,操作简单,骨折愈合率高,患者腕关节功能恢复好。Objective To investigate the clinical efficacy of multi-directional stereotaxic fixation with intramedullary bone grafting in the treatment of nonunion of scaphoid fractures.Methods Twenty patients with nonunion of scaphoid fractures were treated with multi-directional stereoscopic fixation and intramedullary bone grafting.The intraoperative bleeding volume,operative time,fracture healing and complications occurrence were recorded,and the efficacy was assessed using the modified Mayo wrist score criterion.Results Intraoperative bleeding ranged from 15 ml to 60 ml and operative time was 42~83 min.All patients were followed up for 9~24 months.There were no complications such as infection or fracture of the internal fixation.All fractures got bony healing within 3~15 months.At the final follow-up,the outcome was assessed using the modified Mayo wrist score:excellent in 15 cases,good 3 cases,and fair 2 cases,with an excellent-good rate of 18/20.Conclusions The treatment of nonunion of scaphoid fracture with multi-directional stereoscopic fixation and intramedullary bone grafting is simple,with a high fracture healing rate and good functional recovery of the wrist joint.

关 键 词：手舟骨骨折不愈合 多方向立体固定 髓内植骨 

分 类 号：R683.41[医药卫生—骨科学] R687.33[医药卫生—外科学]