经皮双头加压螺钉固定结合中药熏洗治疗腕舟状骨骨折疗效分析

目的:对比经皮双头加压螺钉固定结合中药熏洗与石膏外固定治疗新鲜腕舟状骨骨折的临床疗效。方法:手术组14例用经皮双头加压螺钉固定并中药熏洗治疗,石膏组14例用石膏固定治疗。结果:两组随访9～16个月,平均13.3个月。手术组14例骨折全部愈合,按照Cooney腕关节功能评定优11例、良2例、可1例、差0例、优良率92.86%。石膏组有13例骨性愈合,关节功能评定优6例、良3例、可4例、差1例,优良率64.28%。两组疗效比较有显著性差异(P<0.05)。结论:经皮双头加压螺钉固定结合中药熏洗治疗新鲜腕舟状骨骨折疗效优于石膏外固定,具有简便微创,缩短石膏固定时间,减少骨不愈合发生率的优点。

Objective：To compare the clinical results of percutaneous Double ends compressive screw fixation with Herbal fumigation and cast immobiliztion for fresh scaphoid fractures.Methods：Retrospectively analyse 28 patients with fresh scaphoid fractures who were treated by Percutaneous Double ends compressive screw fixation with Herbal fumigation and cast immobiliztion from Dec.2007 to Dec.2012,were divided into two groups,percutaneous Double ends compressive screw fixation with Herbal fumigation group（14 cases） and cast immobiliztion group（14 cases） were all fresh scaphoid fractures,there was no significant difference in the general information.Results：Two groups cases were followed up for 9-16 months,average of 13.3 months.All patients in percutaneous double ends compressive screw fixation with herbal fumigation group achieved bony union,according to Cooney functional grading system,11 case was excellent,2 cases were good,1 cases were fair,0 cases were poor,the excellent and good rate was 92.86%。13 out of 14 in the cast group achieved bony union,6 case was excellent,3 cases were good,4 cases were fair,1 cases were poor,the excellent and good rate was 64.28%。There was significance difference between 2groups（P ＆lt; 0.05）.Conclusion：Treatment of fresh scaphoid fracture by Percutaneous Double ends compressive screw fixation with Herbal fumigation has better results than cast immobiliztion,it is simple,minimally invasive,effectively shorten the gypsum fixed time,reduce the incidence of nonunion.