切开复位内固定治疗移位舟骨骨折

Open reduction and internal fixation to treat displaced scaphoid fractures

目的评价切开复位Acutrak螺钉内固定治疗急性移位舟骨骨折的愈合情况、并发症和腕部功能恢复情况。方法回顾分析2016年1月-2017年10月采用切开复位Acutrak螺钉内固定治疗的16例急性移位舟骨骨折患者资料。术后平均随访12.6个月(10~18个月)。记录骨折愈合率、骨折愈合时间及术后并发症。通过腕部疼痛、腕关节的活动度、握力、Cooney腕关节评分指标评价腕部功能恢复情况。结果 16例舟骨骨折全部愈合,骨折愈合率为100%,骨折平均愈合时间为9周(8~12周)。16例中,无疼痛14例,2例在腕部剧烈活动时有轻度疼痛;所有患者均恢复原工作;活动不受影响9例,活动达对侧功能75%~99%的7例。握力无影响12例,握力达对侧75%~99%的4例;Cooney腕关节评分:优12例,良2例,可2例。结论切开复位Acutrak螺钉内固定治疗急性移位舟骨骨折愈合率高,愈合时间短,腕部功能恢复良好且并发症少。

Objective To evaluate the results of open reduction and internal fixation of acute displaced fractures of the scaphoid using the Acutrak screw in terms of union condition,complications and functional results. Methods Review sixteen patients with acute displaced fractures of the scaphoid were treated with open reduction and internal fixation using the Acutrak screw between January 2016 and October 2017 in our hospital.All the patients were followed up an average of 12.6 months(range,10-18 months). The rate of union, the time to union, complications were recorded.Evaluate the wrist functional results through the wrist pain, wrist activity, grip strength and the Cooney wrist score. Results All the sixteen fractures(100%) united. The average time to union was 9 weeks(range,8-12 weeks). There were14 cases without pain and 2 cases with mild pain when vigorous activities. All were restored to the original work. The wrist range of motion was not affected in 9 cases, was 75%-99% of normal side in 7 cases. Grip strength was not affected in 12 cases, was 75%-99% of normal side in 4 cases. According to the Cooney wrist score:excellent in 14 cases, good in 2 cases,fair in 2 cases.Conclusion Open reduction and internal fixation of acute displaced fractures of the scaphoid using the Acutrak screw can obtain high union rate,short time to union, well wrist function recovery, minimal complications.