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针头引导下经皮无头空心加压螺钉内固定治疗急性腕舟状骨非移位性骨折
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作者Author单位UnitE-Mail
刘永国 LIU Yong-guo 江汉大学附属黄陂区人民医院骨科, 湖北 武汉 430300 Department of Orthopaedics, Jianghan University Affiliated Huangpi People's Hospital, Wuhan 430300, Hubei, China  
李红军 LI Hong-jun 江汉大学附属黄陂区人民医院骨科, 湖北 武汉 430300 Department of Orthopaedics, Jianghan University Affiliated Huangpi People's Hospital, Wuhan 430300, Hubei, China lihongjun7172@163.com 
期刊信息:《中国骨伤》2023年36卷,第2期,第161-164页
DOI:10.12200/j.issn.1003-0034.2023.02.013


目的:探讨针头引导下经皮空心加压螺钉内固定治疗急性腕舟状骨非移位骨折的疗效。

方法:回顾性分析2014年1月至2019年1月治疗的急性舟状骨非移位性骨折患者28例,根据术中置入空心螺钉导针方法的不同分为引导组(16例)和常规组(12例)。引导组男13例,女3例,年龄20~60(31.42±9.71)岁;Herbert A2型5例,B1型3例,B2型8例,采取针头引导下经皮空心加压螺钉内固定;常规组男11例,女1例,年龄23~61(30.51±7.52)岁;Herbert A2型5例,B1型2例,B2型5例,采取常规经皮空心加压螺钉内固定。观察并对比两组患者的手术时间、术后正侧位X线片螺钉与舟状骨长轴夹角、腕关节功能评分。

结果:28例患者获随访,时间20~45(33.00±8.72)个月。所有患者无术中并发症,无手术切口感染,术后2周逐步恢复工作,骨折12周内均愈合。在手术时间上,引导组少于常规组(P<0.05)。在术后X线片螺钉与舟状骨轴线夹角上,引导组小于常规组(P<0.05)。末次随访Mayo腕关节功能评分差异均无统计学意义(P>0.05)。随访期内28例患者未出现内固定移位、关节炎、舟状骨坏死等并发症。

结论:针头引导下经皮空心加压螺钉内固定治疗急性腕舟状骨非移位性骨折可节省手术时间,螺钉位置更容易与舟状骨长轴平行。
[关键词]:舟状骨  骨折  骨螺钉    骨折内固定
 
Treatment of acute non-displaced scaphoid fracture of wrist with syringe needle-guided percutaneous cannulated headless hollow compression screw internal fixation
Abstract:

Objective To investigate the clinical efficacy of needle-guided percutaneous cannulated compression screw fixation in the treatment of acute non-displaced scaphoid fracture of wrist.

Methods The clinic data of twenty-eight patients with acute non-displaced scaphoid fracture from January 2014 to January 2019 were analyzed retrospectively.According to the intraoperative method of placement of cannulated screw,they were divided into Guide group (16 patients) and Conventional group (12 patients).There were 13 males and 3 females in Guide group,aged from 20 to 60 years old with an average of (31.42±9.71) years old;5 patients were classified as type A2,3 patients were classified as type B1 and 8 patients were classified as type B2 according to Herbert classification;they were treated with percutaneous cannulated compression screw fixation under the guidance of needle.There were 11 males and 1 female in Conventional group,aged from 23 to 61 years old with an average of (30.51±7.52) years old;5 patients were classified as type A2,2 patients were classified as type B1 and 5 patients were classified as type B2 according to Herbert classification;they were treated with conventional percutaneous cannulated compression screw fixation.The operation time,screw angle relative to the longitudinal axis of the scaphoid and wrist function score were assessed and compared between the two groups.

Results A total of 28 patients were followed up from 20 to 45 months with an average of (33.00±8.72) months.None of patients had intraoperative complication and incision infection.These patients returned to work gradually 2 weeks after operation,and all fractures healed within 12 weeks.The operation time in the Guide group was significantly less than that in the Conventinal group (P<0.05).Screw angle relative to the longitudinal axis of the scaphoid in the Guide group was significantly smaller than that in the Conventional group (P<0.05).There was no significant difference in Mayo wrist function scores at the last follow-up between the two groups (P>0.05).During the follow-up period,none of the 28 patients showed internal fixation displacement,arthritis,scaphoid necrosis and other complications.

Conclusion In the treatment of acute non-displaced scaphoid fractures,the operation time of needle-guided percutaneous cannulated headless compression screw fixation is significantly shorter than that of conventional percutaneous screw fixation,and the screw axis is easier to be parallel to the longitudinal axis of the scaphoid.
KEYWORDS:Scaphoid bone  Fractures  Screws  Needle  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:刘永国,李红军.针头引导下经皮无头空心加压螺钉内固定治疗急性腕舟状骨非移位性骨折[J].中国骨伤,2023,36(2):161~164
英文格式:LIU Yong-guo,LI Hong-jun.Treatment of acute non-displaced scaphoid fracture of wrist with syringe needle-guided percutaneous cannulated headless hollow compression screw internal fixation[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(2):161~164
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