经舟骨月骨周围脱位的治疗探讨

目的探讨经舟骨月骨周围脱位的治疗方法。方法回顾分析我院2001年3月～2011年6月治疗经舟骨月骨周围脱位患者19例,经舟骨月骨周围脱位的治疗原则都是早期诊断、早期治疗、解剖复位、坚强固定。首先采用手法复位,若复位后不稳定或复位失败,则需手术治疗。Herbert螺钉是用钛合金制作的双头螺丝钉,可提供较坚强的骨折端固定,因而术后无需长期的石膏固定,仅需固定4周即可。短期的制动是为了术后早期进行功能锻炼,也是取得优良治疗效果的重要因素。结果 19例获得平均24(9～38)个月的随访,17例舟骨骨折愈合,腕关节功能恢复良好;2例出现骨不连,腕关节功能部分受限。尚未发现月骨坏死者。采用Cooney评分法:优9例、良6例、可2例和差2例,优良率78.9%。结论经舟骨月骨周围脱位早期精确的解剖复位,坚强内固定治疗,早期功能锻炼是提高疗效的关键。

Discussion by treatment for the dislocation of the scaphoid bone around

Objective Explore the treatment of dislocation of the scaphoid bone around.Methods Recalling the analysis of our hospital in March 2001 to June 2011,surgery around Thescaphoid dislocation 19 patients with dislocation of scaphoid bone around the principle ofearly diagnosis,early treatment,anatomical reduction,rigid and fixed.First manipulative reduction,if unstable after a reset or reset failure,requiring surgery.Herbert screw isproduced with titanium-headed screws,can provide a strong fracture fixed after surgery,and thus no long-term cast immobilization,only fixed for four weeks.The short-termbraking is an important factor in the early postoperative functional exercise,but also to obtain a good therapeutic effect.Results 19 cases an average of 24(9～38) months follow-up,17 cases of scaphoid fracturehealing,recovery of wrist function;two cases of bone nonunion,part of the wrist function islimited.Have not yet found the lunatebone necrosis.Using the Cooney score: excellent in9 cases,good in 6 cases,2 cases and poor in 2 cases,good rate of 78.9%.Conclusion By aroundthe dislocation of the scaphoid early accurate anatomical reduction and rigid internal fixation for the treatment of early functional exercise is the key to improve the efficacy.