伴月骨周围不稳定的舟骨骨折

目的：探讨日本名古屋地区伴月骨周围不稳定舟骨骨折的发生率、相关因素、诊断和治疗。方法：对11例经腕关节镜检查确认系伴月骨周围韧带损伤的病例进行了回顾性研究，分析其临床特点、治疗方法和疗效。结果：舟骨骨折中，合并舟月或月三角韧带损伤的发生率为20．4％，其韧带损伤与左腕受伤显著相关，63．6％合并近排腕骨背伸不稳定（dorsal intercalated segment instability,DISI), 仅有1例可见明显的舟月分离。通过对应治疗，其疗效与单纯舟骨骨折相比无明显差别。结论：伴月骨周围不稳定的舟骨骨折并不罕见，腕关节镜检查可提高其检出率，积极治疗可取得较好的疗效。

Scaphoid fracture with perilunate instability

Objective To explore the incidence, risk factors, diagnosis and treatment of scaphoid fracture with perilunate instability in Japan. Methods Eleven scaphoid fracture cases with either perilunate ligament injuries verified by wrist arthroscopy were studied retrospectively. The clinical features, treatment methods and the surgical results were analysed. Results The incidence of scaphoid fracture in combination with scapholunate ligament or lunato triquetral ligament injuries accounted for 20.4%. The ligament injuries were significantly related to the left wrist trauma,and 63.6% had dorsal intercalated segment instability (DISI). Scapholunate dissociation was only seen in one patient. With appropriate treatment, there was no significant difference in treatment outcome when compared with isolated scaphoid fracture. Conclusion The incidence of scaphoid fracture with perilunate instability is not a rare disorder. Wrist arthroscopy can improve detection rate Good results can be achieved by proper and active treatments.