腕舟骨骨折关节镜检查的结果及其意义

The result and significance of arthroscopy in scaphoid fracture

目的 应用腕关节镜研究腕舟骨骨折后腕关节的反应、合并软组织、软骨损伤与腕骨排列的异常。方法 分析了 5 8例次腕舟骨骨折患者的关节镜检查结果 ,镜检中重点观察了腕关节滑膜、关节软骨、掌侧韧带、骨间韧带、三角纤维软骨和骨折线等内容。结果 舟骨骨折后滑膜增生开始于伤后 2周 ,并经历了波浪式的消涨过程 ,其增生与否与骨折移位无相关性 (P >0 .0 5 ) ;关节软骨的破坏最早在伤后 5周即有表现 ,并有较大比例的患者合并韧带和三角纤维软骨损伤。结论 腕关节镜检查能更清楚地观察腕关节的病变 ,并为完善诊断和制定治疗计划提供有力的依据。

Objective To explore the wrist joint reaction after scaphoid fracture under arthroscope, and its associated soft tissue and carltilage injuries and wrist instability. Methods Fifty-eight scaphoid fracture arthroscopy results were studied. The wrist joint synovium, articular cartilage, volar ligament, interosseous ligament, triangle fibrous cartilage (TFC) and fracture line were focused on. Results The synovium proliferation started at 2 weeks after scaphoid fracture, undergoing a wave-like process. Whether proliferation or not had no connection with the displacement of fracture. The damage of articular cartilage occurred as early as at 5 weeks after injury. Quite a lot of patients were accompanied ligament and TFC injuries. Conclusion Arthroscopy can observe the pathological changes of the involved wrist joint more clearly, and provide a rational basis for accurate diagnosis and proper treatment.