逆行掌侧螺钉内固定治疗战士腕舟骨骨折

目的探讨逆行掌侧螺钉内固定治疗战士腕舟骨骨折的手术疗效。方法对14例战士腕舟骨骨折采用掌侧切开复位逆行螺钉内固定治疗,用Cooney’s临床评分系统对患腕的疼痛情况,腕关节活动度及握力进行评分。结果14例中有13例愈合,1例不愈合,平均愈合时间为12周,平均腕关节活动度为健侧的90%,握力为健侧的95%,12例患者没有疼痛,1例轻度疼痛,另外l例不愈合有中度疼痛,除1例不愈合患者外,其余都能胜任原有的工作,按Cooney’s评分10例优,3例良,1例差。结论逆行掌侧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 Screws to Treatment of Scaphoid Fracture by Palm-side Retrograde Internal Fixation in Young Soldiers

Objective To evaluate the therapeutic results of scaphoid fracture of young soldiers with palm-side retrograde internal fixation using screws.Methods Fourteen cases of soldiers'scaphoid fracture were treated with screws by palm-side retrograde internal fixation.Cooney's clinical evaluation system was used to evaluate the results according to wrist pain,moving extension and gripping strength.Results In the 14 cases,13 achieved bone union and one nonunion.The mean time of union was 12 weeks.The wrist mean motion range was about 90% of the healthy lateral wrist and mean gripping strength was about 95%.Twelve patients suffered from no pain,one patient from slight pain,and one patient with nonunion from medial pain.According to Cooney's clinical evaluation system, the outcome was fine in 10,good in three and bad in one patient(s).Conclusion Palm-side retrograde internal fixation with screws for soldiers' scaphoid fracture has some advantage such as simple operation,little destruction to remanent blood supply,stable fixation,reduced bone healing time and increased healing rate,so it is an effective way to the treatment of scaphoid fracture.