空心螺钉不同置入方法治疗腕舟状骨骨折疗效比较

发布时间：2018-02-21 00:26

本文关键词： 腕舟状骨骨折腕舟状骨近极腕舟状骨远极骨折内固定术随访研究　出处：《中国矫形外科杂志》2017年10期 　论文类型：期刊论文

【摘要】：[目的]评价腕掌侧入路加压螺钉由腕舟状骨近极向远极固定和由远极向近极固定对腕舟状骨骨折患者骨折预后及功能恢复的临床疗效。[方法]采用腕掌侧入路加压螺钉治疗48例腕舟状骨骨折患者,均为跌伤,按手术方法不同分为两组,近极向远极组:由腕舟状骨近极向远极固定(23例),远极向近极组:由腕舟状骨远极向近极固定(25例)。随访并比较两组间骨折愈合时间、愈合率及腕关节功能Cooney评分和DASH问卷调查表结果。[结果]近极向远极组有20例获得骨性愈合,愈合率86.9%,平均愈合时间(10.52±2.85)周,远极向近极组有19例获得骨性愈合,愈合率76%,平均愈合时间(14.31±1.98)周,两组比较差异有统计学意义(P0.05)。Cooney评分结果:近极向远极组:优11例,良7例,中1例,差1例,优良率78.26%;远极向近极组:优9例,良4例,中2例,差4例,优良率52%,两组比较差异有统计学意义(P0.05)。DASH问卷调查表评分:近极向远极组平均值(7.32±1.28)分,低于远极向近极组的(9.58±3.24)分,差异有统计学意义(P0.05)。[结论]腕掌侧入路加压螺钉采用由近极向远极固定的方法能够较好地保护腕舟状骨血供,比由远极向近极固定更有效地促进骨折愈合及术后腕关节功能的恢复。
[Abstract]:[objective] to evaluate the clinical effect of compression screw fixation from proximal pole to distal pole of scaphoid bone and distal pole fixation on the prognosis and functional recovery of carpal scaphoid fractures. [methods]. Treatment of 48 cases of Carpal scaphoid fracture with Compression Screw, According to the different surgical methods, they were divided into two groups: the proximal pole group: 23 cases were fixed from the carpal scaphoid bone to the distal pole, and the distal pole group: 25 cases were fixed from the carpal scaphoid bone to the proximal pole. The time of fracture healing between the two groups was compared and followed up. The healing rate and Cooney score of wrist joint function and the results of DASH questionnaire. [results] the bone healing rate was 86.9 in the near polar distal group, and the average healing time was 10.52 卤2.85 weeks. 19 patients in the far polar proximal pole group got bone healing, and the average healing time was 10.52 卤2.85 weeks. The healing rate was 76 and the average healing time was 14.31 卤1.98 weeks. The difference between the two groups was statistically significant (P 0.05). Cooney score: 11 cases were excellent, 7 cases were good, 1 case was fair, 1 case was poor, the excellent and good rate was 78.26% in the near polar group, 9 cases were excellent, 4 cases were good, 2 cases were middle in the near polar group. 4 cases were poor, the excellent and good rate was 52%. The difference between the two groups was statistically significant (P 0.05) .DASH questionnaire score: the average value of the near polar group was 7.32 卤1.28), which was lower than that of the far pole group (9.58 卤3.24). The difference was statistically significant (P 0.05). [conclusion] the method of proximal pole to distal fixation can protect the blood supply of carpal scaphoid bone. It is more effective to promote fracture healing and wrist function recovery than distal to proximal fixation.
【作者单位】：南通大学附属吴江医院苏州市吴江区第一人民医院;上海交通大学附属第六人民医院;
【基金】：苏州市科技局项目(编号:SYS201502)
【分类号】：R687.3

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