發(fā)布時(shí)間：2018-01-19 05:06

  本文關(guān)鍵詞： 經(jīng)舟骨月骨周圍脫位 支架外固定 石膏托固定　出處：《蘇州大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景:腕骨月骨周圍骨折脫位約占腕部損傷的10%,其中又以經(jīng)舟狀骨月骨周圍脫位多見,約占3%-5%[1]。背側(cè)型舟骨骨折伴月骨周圍脫位是此類損傷中最常見的類型,腕關(guān)節(jié)CT三維重建可清晰顯示月骨、頭狀骨、舟骨及第三掌骨關(guān)系。目前國內(nèi)外對經(jīng)舟骨月骨周圍脫位治療方法無統(tǒng)一標(biāo)準(zhǔn),療效不一,而如果延誤治療或者錯(cuò)誤治療,后期往往導(dǎo)致近排腕骨切除[2][3],有較高的致殘率。目的:探討利用外固定支架結(jié)合空心釘克氏針在治療經(jīng)舟骨月骨周圍脫位中的臨床療效,為臨床治療經(jīng)舟骨骨折月骨周圍脫位提供更好的理論及實(shí)際操作依據(jù)。方法:18例臨床病人分為兩組,9例行腕關(guān)節(jié)外固定支架固定,同時(shí)行腕部切開復(fù)位,空心螺釘固定舟狀骨骨折,克氏針臨時(shí)固定月頭關(guān)節(jié),修復(fù)腕骨間韌帶;9例行空心螺釘固定舟狀骨骨折,克氏針臨時(shí)固定月頭關(guān)節(jié),修復(fù)腕骨間韌帶后石膏外固定.隨訪1-2年。通過對腕關(guān)節(jié)屈伸、尺偏、橈偏、Cooney評分的統(tǒng)計(jì)分析評價(jià)腕關(guān)節(jié)功能。結(jié)果:外固定支架結(jié)合克氏針空心釘組與石膏結(jié)合克氏針空心釘組各統(tǒng)計(jì)數(shù)據(jù)行t檢驗(yàn)分析,腕關(guān)節(jié)屈伸、Cooney評分P0.05,差異有統(tǒng)計(jì)學(xué)意義,腕關(guān)節(jié)尺橈偏P0.05,差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:外固定支架結(jié)合空心釘克氏針在經(jīng)舟骨月骨周圍脫位的治療中發(fā)揮著重要的作用,有利于韌帶早期修復(fù)及腕關(guān)節(jié)功能的早期恢復(fù),療效滿意。
[Abstract]:Background: peri-carpal fractures and dislocations account for about 10 of the wrist injuries, and peri-scaphoid dislocation is more common, accounting for 3- 5%. [1. Dorsal scaphoid fracture with peri-meniscus dislocation is the most common type of injury. Three-dimensional reconstruction of wrist CT can clearly display the lunar bone and capitate bone. The relationship between scaphoid and third metacarpal bone. At present, there is no uniform standard in the treatment of peri-scaphoid dislocation at home and abroad, and the curative effect is different. However, if the treatment is delayed or mistreated, the proximal carpal excision often occurs in the later stage. [2]. [Objective: to explore the clinical effect of external fixator combined with hollow nail Kirschner needle in the treatment of peri-scaphoid dislocation. To provide a better theoretical and practical basis for the treatment of peri-scaphoid dislocation. Methods 18 cases of clinical patients were divided into two groups: 9 cases were treated with external fixation of wrist joint and the other 9 cases were treated with open reduction of wrist at the same time. Hollow screw fixation of scaphoid fracture, Kirschner needle temporary fixation of the lunar head joint, repair of the interosseous ligament; Nine cases were treated with hollow screw fixation of scaphoid bone fracture, Kirschner's needle was used to fix the lunar head joint temporarily, and the interosseous ligament was repaired with plaster external fixation. The follow-up was 1-2 years. The wrist joint was flexion and extension, ulnar deviation, radial deviation. Results: the external fixation bracket combined with Kirschner needle hollow nail group and gypsum combined with Kirschner needle hollow nail group were analyzed by t-test and wrist joint flexion and extension. Cooney score P0.05, the difference was statistically significant, wrist ulnar deviation P0.05. Conclusion: external fixator combined with hollow Kirschner needle plays an important role in the treatment of peri-scaphoid dislocation, which is beneficial to early repair of ligaments and early recovery of wrist joint function. The curative effect is satisfactory.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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