| Acutrak无头加压空心螺钉治疗舟骨骨折不愈合 |
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投稿时间：2013-10-22
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| 作者 | Author | 单位 | Address | E-Mail |
| 解冰 |
XIE Bing |
沈阳军区总医院骨科, 辽宁 沈阳 110015 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110015, Liaoning, China |
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| 田竞 |
TIAN Jing |
沈阳军区总医院骨科, 辽宁 沈阳 110015 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110015, Liaoning, China |
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| 刘兵 |
LIU Bing |
沈阳军区总医院骨科, 辽宁 沈阳 110015 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110015, Liaoning, China |
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| 荆延峰 |
JING Yan-feng |
沈阳军区总医院骨科, 辽宁 沈阳 110015 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110015, Liaoning, China |
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| 薛海鹏 |
XUE Hai-peng |
沈阳军区总医院骨科, 辽宁 沈阳 110015 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110015, Liaoning, China |
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| 周大鹏 |
ZHOU Da-peng |
沈阳军区总医院骨科, 辽宁 沈阳 110015 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110015, Liaoning, China |
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| 项良碧 |
XIANG Liang-bi |
沈阳军区总医院骨科, 辽宁 沈阳 110015 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110015, Liaoning, China |
xiangliangbi1963@163.com |
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| 期刊信息：《中国骨伤》2014年，第27卷，第3期，第183-186页 |
| DOI：10.3969/j.issn.1003-0034.2014.03.003 |
| 基金项目: |
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中文摘要:
目的：探讨Acutrak无头加压空心螺钉治疗舟骨骨折不愈合的早期疗效。
方法：自2008年1月至2011年7月共收治21例舟骨骨折不愈合患者，男18例，女3例，平均年龄（23.6±4.6）岁。右侧12例，左侧9例。根据Herbert-Fisher分型：D1型10例，D2型7例，D3型3例，D4型1例。受伤至手术时间（12.4±2.7）个月。所有患者采用Acutrak无头加压空心螺钉固定，其中6例行2枚螺钉固定，15例行1枚螺钉固定；7例固定同时行Matti-Russe植骨。测量手术前后腕骨高度、舟骨指数及舟月角变化。记录腕关节活动范围及握力，并采用PRWE评分评定手术效果。
结果：21例平均随访（21.3±3.6）个月。骨折均影像学愈合，平均愈合时间（13.3±2.4）周。无明显围手术期并发症发生。术后舟骨指数及舟月角分别为0.69±0.10和（44.3±8.2）°，较术前的0.61±0.13和（59.4±6.8）°明显改善（P<0.05）.握力显着提高，疼痛明显缓解。术后PRWE评分高于术前（76.1±5.2 vs 45.2±4.7，P<0.05）.21例术后均返回原工作岗位，平均时间（6.0±1.1）个月。
结论：对于舟骨骨折不愈合，Acutrak无头加压空心螺钉固定能达到舟骨解剖复位，术后愈合率高，腕关节功能恢复较好，早期疗效满意。 |
| 【关键词】舟骨 骨折，不愈合 骨折固定术，内 |
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| Acutrak headless compression screw fixation for the treatment of scaphoid non-union |
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ABSTRACT
Objective: To evaluate the early clinical and radiographic outcome of scaphoid non-unions treated with Acutrak headless compression screw.
Methods: From January 2008 to July 2011,21 patients with scaphoid non-union were treated in our department. There were 18 males and 3 females with a mean age of(23.6±4.6) years; 12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification,there were 10 cases with type D1,7 cases with type D2,3 cases with type D3,and 1 case with type D4. The mean time from injury to operation was(12.4±2.7) months. All patients were treated with Acutrak headless compression screw fixation(6 cases received 2 screws fixation,15 cases received 1 screw fixation,and Matti-Russe bone grafting was applied in 7 cases). The carpal height,the scaphoid index and changes of the scapholunate angle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation(PRWE).
Results: Average duration of follow-up was(21.3±3.6) months. All the patients attained radiological union in a mean time of(13.3±2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61±0.13 and the preoperative mean scapholunate angle of(59.4±6.8)° to be improved to 0.69±0.10 and(44.3±8.2)° postoperatively,respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2±4.7 was improved to 76.1±5.2 postoperatively. All patients returned back to the original work,the average time from surgery to work was(6.0±1.1) months.
Conclusion: For scaphoid non-unions,Acutrak headless compression screw fixation can provide anatomical reduction,provide satisfactory results with a high union rate,well return of function and minimal complications in the early stage. |
| KEY WORDS Scaphoid bone Fractures,ununited Fracture fixation,internal |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 解冰,田竞,刘兵,荆延峰,薛海鹏,周大鹏,项良碧.Acutrak无头加压空心螺钉治疗舟骨骨折不愈合[J].中国骨伤,2014,27(3):183~186 |
| 英文格式: | XIE Bing,TIAN Jing,LIU Bing,JING Yan-feng,XUE Hai-peng,ZHOU Da-peng,XIANG Liang-bi.Acutrak headless compression screw fixation for the treatment of scaphoid non-union[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(3):183~186 |
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