[1]牛升波,曹学成.切开复位内固定治疗急性经舟骨月骨周围脱位[J].中医正骨,2015,27(04):59-61.
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切开复位内固定治疗急性经舟骨月骨周围脱位()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年04期
页码:
59-61
栏目:
临床报道
出版日期:
2015-04-30

文章信息/Info

作者:
牛升波曹学成
第二军医大学济南军区总医院临床医学院,山东 济南 250031
关键词:
腕关节 舟骨 月骨 经舟骨月骨周围脱位 骨折固定术
摘要:
目的:探讨切开复位内固定治疗急性经舟骨月骨周围脱位的临床疗效和安全性。方法:2009年6月至2012年6月,采用切开复位Herbert螺钉内固定治疗急性经舟骨月骨周围脱位患者14例,男10例,女4例; 年龄18~71岁,中位数35.5岁。左侧5例,右侧9例; 骑自行车摔伤6例,高处坠落摔伤4例,跌倒摔伤2例,机器牵拉伤2例。其中8例合并正中神经损伤症状。伤后至手术时间3 h至7 d,中位数3 d。随访观察患者的骨折愈合情况、腕关节功能恢复情况及并发症发生情况。结果:14例患者均获随访,随访时间24~42个月,中位数30.5个月。所有舟骨骨折均愈合,术前合并正中神经损伤症状者均恢复。未发生创伤性关节炎、腕关节不稳及腕骨缺血性坏死。12例患者重新回到原工作岗位,其余2例患者可以从事日常家务劳动,所有患者均自诉不能提起过重物体,但均未要求二次手术。术后24个月按照Mayo标准评定疗效,优4例、良7例、可2例、差1例。结论:切开复位内固定治疗急性经舟骨月骨周围脱位,能够有效恢复腕骨正常序列,提供周围韧带修复的结构基础,骨折愈合率高,患肢功能恢复良好,并发症发生率低。

参考文献/References:

[1] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].3版.北京:人民军医出版社,2005:464-468.
[2] Massoud AH,Naam NH.Functional outcome of open reduction of chronic perilunate injuries[J].J Hand Surg Am,2012,37(9):1852-1860.
[3] Herzberg G,Comtet JJ,Linscheid RL,et al.Perilunate dislocations and fracture-dislocations:a multicenter study[J].J Hand Surg Am,1993,18(5):768-779.
[4] Larsen CF,Amadio PC,Gilula LA,et al.Analysis of carpal instability:I.Description of the scheme[J].J Hand Surg Am,1995,20A(5):757-764.
[5] 骆东山.月骨周围腕骨背侧脱位漏诊原因浅析[J].中国骨与关节损伤杂志,2010,25(2):160-161.
[6] Buijze GA,Guitton TG,Van Dijk CN,et al.Training improves interobserver reliability for the diagnosis of scaphoid fracture displacement[J].Clin Orthop Relat Res,2012,470(7):2029-2034.
[7] Murthy NS.The role of magnetic resonance imaging in scaphoid fractures[J].J Hand Surg Am,2013,38(10):2047-2054.
[8] Larsen CF,Bröndum V.Posttraumatic carpal instability.A 9-year follow-up of 18 patients[J].Acta Orthop Scand,1993,64(4):465-468.
[9] Divecha HM,Clarke JV,Barnes SJ.Established non-union of an operatively managed trans-scaphoid perilunate fracture dislocation progressing to spontaneous union[J].J Orthop Traumatol,2011,12(3):159-162.
[10] Forli A,Courvoisier A,Wimsey S,et al.Perilunate dislocations and transscaphoid perilunate fracture-dislocations:a retrospective study with minimum ten-year follow-up[J].J Hand Surg Am,2010,35(1):62-68.
[11] Dhillon MS,Prabhakar S,Bali K,et al.Functional outcome of neglected perilunate dislocations treated with open reduction and internal fixation[J].Indian J Orthop,2011,45(5):427-431.
[12] Garg B,Goyal T,Kotwal PP.Staged reduction of neglected transscaphoid perilunate fracture dislocation:a report of 16 cases[J].J Orthop Surg Res,2012,7(1):19.
[13] Kim JP,Lee JS,Park MJ.Arthroscopic reduction and percutaneous fixation of perilunate dislocations and fracture-dislocations[J].Arthroscopy,2012,28(2):196-203.e2.
[14] 倘艳锋,李成军,范洪庚.经舟骨月骨周围骨折脱位的诊治分析[J].中国骨与关节损伤杂志,2011,26(9):860-861.
[15] 喻永新,尚如国.掌侧入路与背侧入路对腕舟骨骨折愈合率的影响[J].中医正骨,2014,26(7):20-23.
[16] Drac P,Cizmar I,Manak P,et al.Comparison of the results and complications of palmar and dorsal miniinvasive approaches in the surgery of scaphoid fractures.A prospective randomized study[J].Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub,2014,158(2):277-281.

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备注/Memo

备注/Memo:
2014-11-06收稿 2015-01-05修回
通讯作者:曹学成 E-mail:caoxcheng@aliyun.com
更新日期/Last Update: 2015-04-30