7例经舟骨月骨周围脱位早期内固定治疗效果分析

Treatment Effect Analysis of Seven Cases of Early Internal Fixation for Periodontal and Semilunar Bone Dislocation

目的探讨早期手术内固定治疗经舟骨月骨周围脱位的效果。方法某院2012年1月-2013年1月7例经舟骨月骨周围脱位采用手术进行Herbert螺钉内固定舟骨和(或)辅助克氏针固定月骨周围脱位治疗的患者进行回顾性分析。并进行随访及在术后3个月、6个月、12个月及24个月进行Conney评分测定腕关节恢复情况。结果7例患者骨折平均愈合时间为5.2个月。腕关节X线正侧位片显示各腕骨间关系正常,舟月角平均49°(35°-60°)。无舟月分离、腕骨高度塌陷、近排腕骨背伸不稳定和掌屈不稳定,未见月骨、舟状骨坏死及创伤性关节炎的表现。采用Cooney评分法对患者术后3个月、6个月、12个月及24个月腕关节功能进行评价,其中24个月优良率达100%。结论早期诊断并应用"Herbert螺钉内固定周骨和(或)辅助克氏针固定月骨周围脱位"用于治疗舟骨月骨周围脱位效果良好。

Objective To discuss the treatment effect of early internal fixation for periodontal and semilunar bone dislocation.Methods Seven patients with periodontal and semilunar bone dislocation who were treated by Herbert screw internal fixation and（or） Kuntscher pin fixation were analyzed retrospectively,and wrist joint recovery condition were visited and analyzed by Cooney score 3 months,6 months,12 months and 24 months after the operation from Jan.2012 to Jan.2013.Results The average cure time of 7 patients is 5.2 months.X ray radiographs films show the relationship between carpal bones is normal,average scaphoid lunate angle is 49°（35°-60°）.The conditions of the separation of periodontal and semilunar bone,carpal collapse,dorsal intercalated segment instability,Palm flexion instability,semilunar and navicular bone osteonecrosis and traumatic arthritis are not existed.The excellent and good rate of wrist joint function evaluation after 24 months is 100%.Conclusion The treatment effect of early diagnosis and application of Herbert screw internal fixation and（or） Kuntscher pin fixation for periodontal and semilunar bone dislocation was good.