| 切开复位内外固定结合锚钉修复腕骨间韧带治疗月骨周围损伤 |
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投稿时间：2018-04-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 唐春晖 |
TANG Chun-hui |
内江市第一人民医院骨科, 四川 内江 641000 |
Department of Orthopaedics, the First People's Hospital of Neijiang City, Neijiang 641000, Sichuan, China |
tch426@163.com |
| 姚高文 |
YAO Gao-wen |
内江市第一人民医院骨科, 四川 内江 641000 |
Department of Orthopaedics, the First People's Hospital of Neijiang City, Neijiang 641000, Sichuan, China |
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| 王林 |
WANG Lin |
内江市第一人民医院骨科, 四川 内江 641000 |
Department of Orthopaedics, the First People's Hospital of Neijiang City, Neijiang 641000, Sichuan, China |
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| 罗伟 |
LUO Wei |
内江市第一人民医院骨科, 四川 内江 641000 |
Department of Orthopaedics, the First People's Hospital of Neijiang City, Neijiang 641000, Sichuan, China |
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| 期刊信息：《中国骨伤》2018年，第31卷，第9期，第863-866页 |
| DOI：10.3969/j.issn.1003-0034.2018.09.016 |
| 基金项目: |
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中文摘要:
目的：探讨切开复位内、外联合固定结合锚钉修复腕骨间韧带治疗月骨周围损伤的可行性、技术要点及临床效果。
方法：2012年9月至2016年9月采用克氏针行腕骨间关节固定，3.0 mm空心钉固定舟骨骨折，可吸收锚钉修复腕骨间韧带，联合跨腕关节支架固定治疗月骨周围损伤患者11例，男7例，女4例；年龄29~68岁，平均43.6岁。其中经舟骨骨折月骨周围脱位5例，月骨周围脱位6例，观察内容包括舟月角、桡月角、腕骨高度指数、腕关节活动度等。
结果：所有患者伤口Ⅰ期愈合，11例患者均获得随访，时间12~24个月。X线片示舟月角平均51°（35°~65°），桡月角平均7°（-10°~15°），腕骨高度指数平均0.51（0.50~0.53），5例舟骨骨折均Ⅰ期愈合，未见舟骨及月骨坏死。临床检查腕关节活动度平均为91.5°，握力达健侧的78.5%。腕关节无痛者6例，轻度疼痛者3例，中度疼痛者2例。按照Cooney腕关节评价标准，优8例，良2例，可1例。
结论：早期切开复位内固定，超腕关节支架固定，联合腕骨间韧带修补治疗月骨周围损伤具有手术时间短、创伤小等优点，临床操作安全可行，疗效满意。 |
| 【关键词】月骨 韧带 骨折切开复位 骨折固定术 |
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| Open reduction and internal and external fixation combined with anchor repair of intercarpal ligament for the treatment of peripheral injury of lunate bone |
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ABSTRACT
Objective: To evaluate the feasibility of internal and external fixation after open reduction combined with suture anchors to repair the intercarpal ligaments for the treatment of perilunate injury,and to explore its operative techniques and therapeutic efficacy.
Methods: From September 2012 to September 2016,11 patients with perilunate injury were surgically treated with Kirschner wires in intercarpal articulations,3.0 mm cannulated screws for scaphoid fracture,absorbable anchor for intercarpal ligament repair,together with fixators at intercarpal joints,among whom 6 suffered from perilunate dislocations and 5 from trans-scaphoid fracture dislocations. There were 7 males and 4 females with an average age of 43.6 years old ranging from 29 to 68 years old. Scapho-lunate angle,radio-lunate angle,index of carpal height and ROM of the wrist were observed.
Results: All wounds were healed at stage Ⅰ. All patients were followed up from 12 to 24 months. The height of the carpal was maintained well with a mean scapho-lunate angle of 51°(35° to 65°),mean radio-lunate angle of 7°(-10° to 15°),and mean index of carpal height being 0.51(0.50 to 0.53),5 patients of scaphoid fracture obtained bone union. Necrosis of lunate and scaphoid was not observed. The ROM of the wrist averages about 91.5°. The grip strength was recovered and amounted to 78.5% of that of the contralateral side. Among them,6 cases reported no feeling of pain,3 mild feeling of pain,and 2 medium level of pain. According to Cooney wrist score,8 cases were considered excellent,2 good and 1 fair.
Conclusion: The wrist functions can be obtained satisfactorily by intervening in the early stage through internal and external fixation after open reduction combined with suture anchors to repair intercarpal ligaments for the treatment of perilunate injury. It has advantages of shorter operation time,smaller invasive trauma,less blood loss and etc. Therefore,this technique is safe and practicable,yielding satisfying clinic effects. |
| KEY WORDS Lunate bone Ligaments Open fracture reduction Fracture fixation |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 唐春晖,姚高文,王林,罗伟.切开复位内外固定结合锚钉修复腕骨间韧带治疗月骨周围损伤[J].中国骨伤,2018,31(9):863~866 |
| 英文格式: | TANG Chun-hui,YAO Gao-wen,WANG Lin,LUO Wei.Open reduction and internal and external fixation combined with anchor repair of intercarpal ligament for the treatment of peripheral injury of lunate bone[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(9):863~866 |
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