切开复位加压空心螺钉内固定治疗经舟骨月骨周围骨折-脱位

目的　探讨切开复位加压空心螺钉和克氏针内固定治疗经舟骨月骨周围骨折-脱位的临床效果。 方法　对25例患者采用切开复位、克氏针固定腕骨关节，舟骨骨折复位加压空心螺钉内固定，同时修复关节囊和韧带，术后进行康复治疗。 结果　术后随访7～24个月，平均15个月,根据Cooney腕关节评分标准， 本组优8例、良10例、可5例，差2例，平均评分值82分。X线片检查舟状骨骨折一期愈合，腕关节达解剖复位，腕骨间隙正常。 结论　应用切开复位加压空心螺钉和克氏针内固定，修复关节囊和重要韧带， 有利于腕关节功能的恢复，是治疗经舟骨月骨周围骨折-脱位的较好方法。

The treatment of trans-scaphoid perilunate fracture dislocation:open reduction and internal fixation withcompression hollow screw

Objective To investigate the clinical effects of open reduction,internal fixation with pressure hollow screw and Kirschner wire on trans-scaphoid perilunate fracture-dislocation.Methods 25 cases of trans-scaphoid perilunate fracture-dislocation were treated with open reduction,compression hollow screw fixation of the scaphoid,Kirschner wire fixation of intercarpal joints,followed by the repair of the joint capsule and special ligaments.The postoperative rehabilitation was performed.Results All cases were followed up about 7～24 months with an average of 15 months.The wrist function was evaluated by Cooney scores,with the mean value of 82.8 cases were excellent,10 cases good,5 cases fair and 2 case poor.X-ray displayed that the fractures of scaphoid were healing by first intention and intercarpal joints were reduced.The gap between carpal bones was normal.Conclusions It is helpful for the recovery of wrist function using open reduction,internal fixation with pressure hollow screw and Kirschner wire,and the repair of the joint capsule and ligaments,during the treatment of trans-scaphoid perilunate fracture dislocation.