掌侧入路AO双螺纹空心加压螺钉治疗舟骨骨折

Treatment of scaphoid fractures with AO double thread compression cannulated screw via a volar approach

目的探讨掌侧入路AO双螺纹加压空心螺钉治疗舟骨骨折的适应证、手术方法及疗效。方法2000年3月-2008年1月，通过透视机下复位，取掌侧人路AO双螺纹加压螺钉固定治疗21例新鲜舟骨骨折。术后定期复查X线片，观察骨折愈合情况，按Krimmer评分方法评估腕关节功能。结果术后21例获得3．24个月的随访，平均15个月。21例骨折均为Ⅰ期愈合，愈合时间平均为10周。按Krimmer法评分：优15例，良4例，可2例；优良率为90．5％。结论对于舟骨腰部骨折，通过术中透视机下复位，经掌侧人路应用AO双螺纹加压螺钉固定，手术操作简便，创伤小，术后可早期进行活动，能有效提高骨折愈合率，功能良好。

Objective To discuss the application, operative techniques and the treatment outcome of scaphoid fractures using AO double thread compression cannulated screw via a volar approach. Methods From March 2000 to January 2008, we treated 21 patients with fresh scaplioid waist fractures by close reduction and internal fixation with AO double thread compression cannulated screw via a volar approach under fluoroscope guidance. Plain X-ray was taken on a regular base postoperatively to investigate fracture healing. Wrist function was evaluated according to Krimmer score. Results The patients were followed up for an average of 15 months （ range, 3 to 24 months）. Primary healing of the fractures was seen in all cases with an average healing time of 10 weeks. Wrist function was graded as excellent in 15 eases, good in 4 cases and fair in 2 cases according to Krimmer score evaluation. The overall excellent and good rate was 90.5 %. Conclusion Close reduction and internal fixation with AO double thread compression eannulated screw via a volar approach under fluoroscope guidance is a valid treatment option for scaphoid waist fractures. It is minimally invasive and allows early postoperative rehabilitation which improves fracture healing and functional recovery.