Herbert螺钉微创治疗腕舟骨骨折

目的总结利用Herbert螺钉及微创外科技术治疗腕舟骨骨折的临床应用。方法2006年2月至2009年2月，Herbert螺钉微创治疗18例腕舟骨骨折。术前斜矢状位CT确诊骨折及分型；术中结节部小切口入路，采用克氏针闭合间接撬拨复位技术、导向针一次性穿人技术、Herbert螺钉加压髓内固定技术；术后避免骨折不利活动，循序渐进功能锻炼。结果18例随访4～14个月，平均12个月；均骨性愈合，骨愈合时间7～10周，平均9周；CT示1例螺钉穿透皮质骨；1例轻度畸形愈合；1例术中骨折复位困难，行切开复位内固定；18例均无感染、骨不连、骨坏死、创伤性关节炎等并发症；按Krimmer腕关节功能总体疗效评分，优13例，良3例，满意1例，差1例，优良率为88．9％。结论应用Herbert螺钉及微创外科技术治疗腕舟骨骨折疗效满意，值得临床推广应用。

The Treatment of Scaphoid Fracture with Herbart Screw

Objective To investigate the treatment of scaphoid fracture with Herbart Screw of micro-trauma in clinic. Methods 18 patients of scaphoid fracture with Herbart Screw and grouping before operating by oblique-an- teroposterior axes CT. The small incision was used in operating via Kirschner wire turn reset and targeting wire pene- tration only once. After operation harmful activity was refrained and functional training gradually. Results Follow-up 4~14 moflths in 18 patients,average 12 months,all bone-healing,the healing time from 7 to 10 months,average 9 months. 1 break through the cortical bone, 1 little malformation, 1 reset too difficult to cut open in CT image. All have no complication including infection ,no-conection ,necrosis, osteoarthritis etc. 2 wrists feel little pain and activity handi- cap,grasp force well,according to Krimmer~s score method of total therapeutic effection： 13 excellent ,3 well, 1 satis- faction,88.9% good rate. Conclusion The treatment of scaphoid fracture with Herbart Screw can get firm fixation, miero2trauma,function training and healing early.