可吸收棒内固定治疗陈旧性腕舟骨骨折

目的探讨可吸收棒治疗陈旧性腕舟骨骨折的手术疗效。方法对17例陈旧性腕舟骨骨折,按Herbert分类:D1型4例,D2型11例,D3型2例,采用骨折切开复位自体松质骨植骨,可吸收棒内固定术。结果17例获得4~26个月随访,平均9个月。术后伤口均Ⅰ期愈合,骨折愈合时间8~19周,平均13周。腕关节活动范围掌屈[(49.5±8.5)°,x-±s,下同],(达健侧78.3%);背伸(41.5±4.5)°,(达健侧70.5%);桡偏(16.5±2.5)°,(达健侧57.1%);尺偏(24.5±5.5)°,(达健侧60.3%)。15例腕关节活动时无疼痛。2例有疼痛。腕部握力(24.7±3.1)kg,(达健侧83.2%)。术后X线片示17例均未发生腕骨性关节炎及舟骨缺血性坏死。结论可吸收棒治疗陈旧性舟骨骨折手术操作简单,固定牢靠,可缩短骨折愈合时间及提高骨折愈合率,是治疗陈旧性舟骨骨折的一种有效的手术方法。

The use of self-reinforced absorbable (SR-PLLA) rods for old scaphoid fracture treatment

Objective To evaluate the results of treating old scaphoid fractures with self-reinforced absorbable (SR-PLLA) rods. Methods 17 cases of old scaphoid fractures were involved. According to Herbert classification, there were 4 cases of type D1, 11 cases of type D2, and 2 cases of type D3. All these fractures were treated by open reduction and internal fixation with self-reinforced absorbable (SR-PLLA) rods plus cancellous bone graft. Results Seventeen cases were followed up for 4 months to 26 months, with an average of 9 months. All fractures healed. Bone union was seen 8 weeks postoperatively in 12 patients, 10 weeks in 3 patients, 12 weeks in 1 patient, 15 weeks in 1 patient, and 19 weeks in 1 patient. 15 patients restored normal wrist function and had no pain, while 2 patients had obvious improvement and only pain at motion. Conclusion This operative technique is simple and can achieve reliable fixation. It thus can improve bone healing with a reduced healing time and increased healing rate. This surgical procedure is an effective way to treat old scaphoid fracture.