月骨、三角骨周围性腕骨轴向崩裂症一例

1临床资料患者,男,22岁,因左前臂被对滚机挤压致左手腕关节活动障碍入院。局部检查：左手及左腕关节肿胀明显,活动受限,压痛明显。X线后前位片显示：左腕关节近排腕骨的近侧和远侧弧线的连续性中断,正常的腕中关节间隙消失,     

月骨周围性腕骨掌侧脱位3例报告

月骨周围性腕骨掌侧脱位３例报告贵州省安顺地区医院（５６１０００）杨学舟，曹清峰，孔令震月骨周围性腕骨掌侧脱位是一种临床罕见的腕部损伤，我们收治３例，现报告如下。例１，××，男、２５岁，因右手机器压砸伤后腕部疼痛，出血、活动障碍６小时入院。检查：右腕部...     

月骨周围腕骨背侧脱位漏诊原因浅析

目的探讨月骨周围腕骨背侧脱位漏诊原因分析和治疗原则。方法收治月骨周围腕骨背侧脱位患者20例,来院前漏诊14例。针对不同病例采用不同方法治疗。结果19例获得随访,腕部功能采用Mayo法进行评估,优5例,良7例,可5例,差2例。结论月骨周围腕骨背侧脱位漏诊原因,与腕骨自身体积小,排列较复杂,基层医院认识不足,X线片模糊等诸多因素有关。     

月骨脱位及月骨周围性腕骨脱位的临床分析

本文报道１２例少见的、新鲜的闭合性月骨脱位及月骨周围性腕骨脱位，其中月骨掌侧脱位６例，月骨掌侧脱位合并舟骨骨折３例，月骨周围性腕骨背侧脱位２例，经舟骨月骨周围性腕骨背侧脱位１例，全部以手法复位治疗，随访时间为６个月￣６年。结果：患肢日常生活无障碍者１０例，轻度障碍者２例、本文对其损伤机制、诊断要点、治疗及预后方面作了较详细的阐述。     

近排腕骨切除术治疗陈旧性经舟骨月骨周围骨折-脱位

目的报道近排腕骨切除术治疗陈旧性经舟骨、月骨周围脱位的临床效果。方法对 34例应用此手术的患者进行功能评价,平均随访5年3个月。结果29例腕部疼痛症状消失,5例仍有轻微腕部疼痛不适;腕关节屈伸活动度较术前增加了30°～50°;尺、桡偏活动较差,范围20°～30°;握力较健侧稍减弱;29例恢复了原来的工作,5例改为轻工作。结论近排腕骨切除术是治疗陈旧性经舟骨、月骨周围脱位的一种可靠有效的方法。     

中西医结合治疗经舟骨月骨周围性腕骨脱位

经舟骨月骨周围性腕骨脱位临床并不少见,由于其解剖结构复杂,极易发生漏诊或误诊,以致延误治疗,严重影响腕关节功能.     

经舟状骨骨折月骨周围腕骨脱位误漏诊原因及诊断方法探讨

目的　探讨经舟状骨骨折月骨周围腕骨脱位的损伤病理变化和诊断的关系。方法　回顾性分析 1989年来收治的 6例经舟状骨骨折月骨周围腕骨脱位患者 ,年龄 18～ 2 7岁 ,其中高处坠落伤 2例 ,骑摩托车摔伤 2例 ,跑步摔伤 1例 ,机器压伤 1例。结果　本组中 5例误漏诊 ,时间达 7～ 2 7d。结论　月骨和舟状骨骨折近端解剖位置正常 ,其他腕骨全部脱位命名为经舟状骨骨折月骨周围腕骨脱位更符合损伤病理变化。了解致伤机制、掌握腕部X线解剖 ,对减少本病误漏诊至关重要。     

切开复位克氏针内固定治疗月骨脱位与月骨周围性腕骨脱位

腕骨骨折与脱位临床并不少见，仅拍正侧位片，约有１／５的病例将被漏诊〔１〕，同时，由于对腕关节复杂的解剖生理和生物力学特点理解不够，也是容易产生漏诊或误诊的原因，从而贻误治疗时机，对手的功能影响很大，我们５年来共治疗新鲜的月骨脱位及月骨周围性腕骨脱位１...     

“Twist of the Wrist” A Rare Case of Carpal Dislocation

A rare case of a scaphoid–trapezium dislocation is presented. The treatment was open reduction, ligament repair, and internal fixation with a Kirschner wire. After 4 weeks of immobilization, the Kirschner wire was removed, and full recovery was obtained 12 weeks after the trauma.     

Volar Dislocation of the Triquetrum - Case Report and Review of Literature

In contrast to triquetral fractures, dislocations of the triquetrum are very uncommon because of the very strong ligamentous support. They occasionally occur in association with complex wrist injuries, isolated dislocations however are extremely rare. We report a case of a male athlete who sustained an isolated volar dislocation of the triquetrum. The injury was treated by open reduction, fixation with Kirschner-wires and direct repair of torn ligaments. Kirschner-wires were removed after 6 weeks and physiotherapy was started. At 3 years follow-up he reported to be free of pain and showed only slightly restricted grip strength and range of motion when compared to his uninjured hand. A review of the literature indicates that final outcomes are usually satisfactory if prompt diagnosis and treatment occurs. However persistent pain and impaired hand function may result because of delayed diagnosis or insufficient repair of associated ligament injuries.     

腕骨外生骨软骨瘤

目的探讨腕骨外生骨软骨瘤的发病特点和影像学诊断方法。方法回顾性地分析了17例多发性骨软骨瘤的病例,其中9例在疾病的不同阶段均可见腕骨周围的异常钙化影。通过对这9例患者长期随访的影像学资料进行追踪对比、分析,总结腕骨外生骨软骨瘤的发病特点和影像学的诊断方法。结果本组病例观察到腕骨病变的年龄为3．5～8．0岁,平均[(5．7±1．6)岁,x±s,下同],有5例患者在10．0～15．0岁．平均(12．0±1．9)岁以后,在X线平片中就难以分辨骨软骨瘤的病变了,有3例患者在骨软骨瘤的X线影像与腕骨融合后仍可见腕骨显著的畸形。CT扫描有助于发现某些已经与腕骨融合的瘤体,MRI对腕骨外生骨软骨瘤的诊断并不比CT更敏感。腕骨的外生骨软骨瘤可以累及除豌豆骨外的所有腕骨,其中头状骨受累最为常见,瘤体可出现于一侧或双侧腕关节,受累侧的尺、桡骨和(或)掌、指骨也都有瘤体分布。在腕关节中,瘤体可同时累及两块腕骨,也可有多个瘤体累及一块腕骨。腕骨的瘤体极少影响腕关节的功能。结论腕骨外生骨软骨瘤在多发性骨软骨瘤的患者中较为常见,采用多体位X线平片在患儿的青少年时期较为容易发现异常病变影,CT扫描有助于定位并明确诊断,此类疾病多无需手术治疗。     

Scaphoid dislocation with hamate fracture and proximal migration of distal carpal row

Scaphoid dislocation is a rare injury.Traditionally it has been classified into isolated dislocation and dislocation associated with axial carpal disruption.We present a unique case of scaphoid disloca...     

Scaphoid dislocation with hamate fracture and proximal migration of distal carpal row

Scaphoid dislocation is a rare injury. Traditionally it has been classified into isolated dislocation and dislocation associated with axial carpal disruption. We present a unique case of scaphoid dislocation associated with proximal migration of the entire distal carpal row as a single unit and hamate fracture with no axial carpal disruption. This injury complex has not been previously described in the literature. The purpose of this case report is to emphasize that in absence of axial carpal dissociation with scaphoid dislocation, a careful evaluation of injury to other bones should be done and treated accordingly to maximize the chances of favourable outcome with reconstructive surgery.     

孤立闭合性腕舟骨完全脱位1例

患者,男,40岁,因车祸撞伤左上肢致左前臂腕关节肿胀疼痛、活动受限2d入院。查体:左前臂处有擦痕,肿胀,压痛,左腕关节肿胀明显,掌侧可触及脱位舟骨,腕关节背侧有凹陷感,腕关节屈伸活动明显受限。左腕X线片示:左腕舟骨完全脱位至桡骨远端掌侧(图1a,1b),近极可见细小骨折线。急诊行闭合复位失败后入院,在臂丛麻醉下采用腕背侧入路,经鼻烟窝于腕背部做"S"形切口,切开皮肤、皮下组织,     

Dorsal Carpometacarpal Dislocation of Ulnar Fingers. A Case Report

Multiple dorsal dislocations of the carpometacarpal joints are rare. Diagnosis requires a high index of suspicion, careful examination and good radiography. Treatment is controversial and is based on the presence or not of associated fractures. This paper presents a case of combined fifth and fourth finger carpometacarpal joint dorsal dislocation, successfully treated with closed reduction and percutaneous pinning. A discussion of this pattern of injury is also presented.