闭合复位经皮空心螺钉固定治疗Herbert B1、B2型腕舟状骨骨折

Closed reduction and percutaneous hollow screw fixation for treatment of Herbert type B1,B2 acute scaphoid fractures

目的探讨闭合复位经皮空心螺钉固定治疗轻微移位腕舟状骨骨折的临床疗效。方法对15例Herbert B1、B2型腕舟状骨骨折患者采用闭合复位经皮空心螺钉固定治疗。术后定期摄腕关节X线片评价骨折愈合情况,采用改良Mayo腕关节功能评分及疼痛VAS评分评价功能情况。结果 15例均获得随访,时间6~24个月。患者骨折愈合时间6~12周,未出现骨不愈合及骨坏死。末次随访时,Mayo评分80~100分,其中优11例,良4例;VAS评分为0~3分。结论闭合复位经皮空心螺钉固定创伤小,能最大程度保护舟状骨周围血供,有效避免了舟状骨坏死的发生,且固定牢靠,允许早期功能锻炼,术后功能恢复优良,是治疗Herbert B1、B2型腕舟状骨骨折的有效方法。

Objective To investigate the effect of closed reduction and percutaneous hollow screw fixation for the treatment of scaphoid fractures with slight displacement.Methods The 15 cases of scaphoid fractures of type B 1 and type B2 according to Herbert classification were treated with closed reduction and percutaneous hollow screw fixation.The positive and lateral and oblique radiographs of the wrist were taken regularly to evaluate the fracture healing.The modified Mayo wrist function score and VAS were used to evaluate function results.Results All 15 patients were followed up for 6~24 months.All patients achieved bone union without nonunion or osteonecrosis.The Mayo score was 80~100 points at the last follow-up.Among them, 11 cases were excellent , 4 cases were good.The VAS was 0~3 points.Conclusions Closed reduction and percutaneous hollow screw fixation can minimize soft issue dissection to protect peripheral blood supply , which effectively avoid the bone necrosis , allow patients to do early functional exercise after operation , which is an effective method for the treatment of Herbert type B 1, B2 of wrist fracture of scaphoid bone.