舟骨骨折—月骨周围脱位的诊断与手术治疗的临床研究

目的：总结舟骨骨折月骨周围脱位的诊断和切开复位内固定舟骨骨折同时修复损伤韧带的临床研究。方法：2005年5月至2011年12月共收治患者13例，通过病史、体征结合X光及CT+三维重建明确诊断，采用切开复位腕骨内固定舟骨骨折，同时修复腕骨间韧带，克氏针暂时固定手术治疗。结果：13例患者均受随访，时间24-55个月，平均29.6个月。全部患者舟骨骨折完全愈合，未发现有舟骨近端及月骨缺血性坏死发生，手术前后对腕关节采用Cooney临床评分系统，术后13例患者Cooney评分75-95分，平均87分，优良率可达84.6%。结论：通过病史、体征结合X光及CT+三维重建可明确诊断，早期切开解剖复位内固定结合腕骨间韧带修补及克氏针暂时内固定可防止部分腕骨缺血坏死及腕骨间不稳、腕骨高度塌陷，降低了远期腕关节创伤性关节炎的发生率。

Clinical analysis of the diagnosis and operative treatment for scaphoid bone fracture and semilunal bone dislocation

Objective: To evaluate the diagnosis of scaphoid bone fracture and semilunal bone dislocation and the results of open reduction and internal fixation combined with intercarpal ligament repair for the treatment of this injury. Methods: form May 2005 to December 2011, 13 cases of scaphoid bone fracture and semilunal bone dislocation were treated operatively. There was a clear diagnosis from symptom and X ray and CT, All cases were treated with open reduction and internal fixation combined with intercarpal ligament repair.Results: All cases were followed up from 24 to 55 months, a mean period of 39.6 months. All the scaphoid bone healed primarily. According to clinical scoring of Cooney, the effective rate in postoperation is 84.6%.Conclusion: There was a clear diagnosis from symptom and X ray and CT, There was an effective method to cure this injury with open reduction and internal fixation combined with intercarpal ligament repair.