逆行可吸收拉力螺钉内固定治疗腕舟骨骨折

目的：探讨逆行可吸收拉力螺钉内固定治疗腕舟骨骨折的手术疗效。方法：2001年12月至2007年12月,18例腕舟骨骨折,男12例,女6例;年龄17～40岁,平均26岁。腕舟骨腰部骨折10例,近端骨折8例。采用逆行可吸收拉力螺钉内固定治疗。结果：18例患者获随访,时间12～36个月,平均25个月。18例中有17例愈合,1例不愈合,平均愈合时间为13周,平均腕关节活动度为健侧的90%,握力为健侧的95%。14例无疼痛,3例轻度疼痛,另外1例不愈合有中度疼痛,除1例不愈合外,其余都能胜任原工作。按Cooney评分标准：总评分由术前的（68.2±1.5）分提高到术后的（88.7±1.2）分,术后各项评分明显高于术前（P〈0.05）;优9例,良8例,差1例。结论：逆行可吸收拉力螺钉内固定治疗腕舟骨骨折手术操作简单,对腕舟骨残存的血运破坏小,固定牢靠,可缩短骨折愈合时间及提高骨折愈合率,是治疗腕舟骨骨折的一种有效的手术方法。

Application of absorbable screw in treatment of scaphoid fracture by retrograde internal fixation

Objective: To evaluate the surgical effects of treatment of scaphoid fracture with retrograde internal fixation using absorbable screw. Methods: From December 2001 to December 2007,18 cases of scaphoid fracture were treated with absorbable screw by retrograde internal fixation. There were 12 males and 6 females with an average age of 26 years ranging from 17 to 40 years. Ten cases were medium fractures of scaphoid adn 8 cases were proximal fraxtures. Results: All patients were followed-up for from 12 to 36 months(means 25 months). Among them,17 cases were union and 1 case was nonunion. The mean time of union was 13 weeks. The mean range of motion of wrist was about 90% and mean scratch strength of wrist was about 95% to fine lateral. There were no pain in 14 cases,and slight pain in 3,medial pain in 1 casea of ununion. According to Cooney's clinical evaluation system,the score was increased from(68.2±1.5) before operation to(88.7±1.2) after operation,the postoperative score was higher than preoperative remarkable;9 patients were fine,8 were good and 1 was bad. Conclusion: This technology had some advantage such as simple surgery,decreasing demonstrate rest blood circulation,stable fixation,reducing bone healing time and increasing healing time. It is an effective way to treat scaphoid fracture.