外固定支架结合空心钉克氏针在治疗经舟骨月骨周围脱位中的疗效分析

发布时间：2018-01-19 05:06

本文关键词： 经舟骨月骨周围脱位支架外固定石膏托固定　出处：《苏州大学》2015年硕士论文　论文类型：学位论文

【摘要】：研究背景:腕骨月骨周围骨折脱位约占腕部损伤的10%,其中又以经舟状骨月骨周围脱位多见,约占3%-5%[1]。背侧型舟骨骨折伴月骨周围脱位是此类损伤中最常见的类型,腕关节CT三维重建可清晰显示月骨、头状骨、舟骨及第三掌骨关系。目前国内外对经舟骨月骨周围脱位治疗方法无统一标准,疗效不一,而如果延误治疗或者错误治疗,后期往往导致近排腕骨切除[2][3],有较高的致残率。目的:探讨利用外固定支架结合空心钉克氏针在治疗经舟骨月骨周围脱位中的临床疗效,为临床治疗经舟骨骨折月骨周围脱位提供更好的理论及实际操作依据。方法:18例临床病人分为两组,9例行腕关节外固定支架固定,同时行腕部切开复位,空心螺钉固定舟状骨骨折,克氏针临时固定月头关节,修复腕骨间韧带;9例行空心螺钉固定舟状骨骨折,克氏针临时固定月头关节,修复腕骨间韧带后石膏外固定.随访1-2年。通过对腕关节屈伸、尺偏、桡偏、Cooney评分的统计分析评价腕关节功能。结果:外固定支架结合克氏针空心钉组与石膏结合克氏针空心钉组各统计数据行t检验分析,腕关节屈伸、Cooney评分P0.05,差异有统计学意义,腕关节尺桡偏P0.05,差异无统计学意义。结论:外固定支架结合空心钉克氏针在经舟骨月骨周围脱位的治疗中发挥着重要的作用,有利于韧带早期修复及腕关节功能的早期恢复,疗效满意。
[Abstract]:Background: peri-carpal fractures and dislocations account for about 10 of the wrist injuries, and peri-scaphoid dislocation is more common, accounting for 3- 5%. [1. Dorsal scaphoid fracture with peri-meniscus dislocation is the most common type of injury. Three-dimensional reconstruction of wrist CT can clearly display the lunar bone and capitate bone. The relationship between scaphoid and third metacarpal bone. At present, there is no uniform standard in the treatment of peri-scaphoid dislocation at home and abroad, and the curative effect is different. However, if the treatment is delayed or mistreated, the proximal carpal excision often occurs in the later stage. [2]. [Objective: to explore the clinical effect of external fixator combined with hollow nail Kirschner needle in the treatment of peri-scaphoid dislocation. To provide a better theoretical and practical basis for the treatment of peri-scaphoid dislocation. Methods 18 cases of clinical patients were divided into two groups: 9 cases were treated with external fixation of wrist joint and the other 9 cases were treated with open reduction of wrist at the same time. Hollow screw fixation of scaphoid fracture, Kirschner needle temporary fixation of the lunar head joint, repair of the interosseous ligament; Nine cases were treated with hollow screw fixation of scaphoid bone fracture, Kirschner's needle was used to fix the lunar head joint temporarily, and the interosseous ligament was repaired with plaster external fixation. The follow-up was 1-2 years. The wrist joint was flexion and extension, ulnar deviation, radial deviation. Results: the external fixation bracket combined with Kirschner needle hollow nail group and gypsum combined with Kirschner needle hollow nail group were analyzed by t-test and wrist joint flexion and extension. Cooney score P0.05, the difference was statistically significant, wrist ulnar deviation P0.05. Conclusion: external fixator combined with hollow Kirschner needle plays an important role in the treatment of peri-scaphoid dislocation, which is beneficial to early repair of ligaments and early recovery of wrist joint function. The curative effect is satisfactory.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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