经舟骨月骨周围脱位的诊断和治疗

目的 探讨经舟骨月骨周围脱位的诊断和治疗。方法 回顾性分析17例经舟骨月骨周围脱位病例，背侧型13例，掌侧型4例；新鲜损伤组10例中8例行撬拨复位成功，仅2例因舟骨对位不良接受手术治疗；陈旧性组7例中均接受手术，4例行开放复位内固定，3例行近排腕骨切除术。结果 采用Cooney评价标准，优11例，良3例，可1例，差2例，优良率82．35％。结论 经舟骨月骨周围脱位的早期治疗简单且疗效较好，而一旦误诊，则多数需手术治疗，且残留不同程度的功能障碍。提高对本病损伤机制、腕部体征和影像学特点的认识和了解，减少误诊。是提高本病预后的关键因素之一。

The Diagnosis and Treatment.on Trans- scaphoid Perilunar Dislocation

Objective To analyze the diagnosis and treatment on trans-scaphoid perilunar dislocation(TSPD).Methods Between Nov 2000 and Sep 2005,17 TSPD of the carpus had been treated.13 cases of 17 were dorsal TSPD and the oth- ers were palmar TSPD.Early reduction by closed manipulation was done successfully in 8 cases of 10 fresh injury,open reduction and internal fixation were performed in two for accurate reduction of the scaphoid fracture.Open reduction and internal fixation(4 cases),proximal row carpectomy(3 case)were performed in 7 cases of old injury.Results 11 cases had no pain in wrist and resuming daily activities according to Cooney's standard.3 cases got the same result except having pain in wrist after violent movement.The satisfactory rate was 82.35%(14/17).Conclusions The early treatment of TSPD is simple and has ideal prognosis,which is different from old TSPD.It is very important to comprehend the injury mechanism,signs of wrist and the X-ray anatomy features of TSPD.