本文關(guān)鍵詞： 腕舟狀骨骨折 腕舟狀骨近極 腕舟狀骨遠(yuǎn)極 骨折內(nèi)固定術(shù) 隨訪研究　出處：《中國(guó)矯形外科雜志》2017年10期 　論文類型：期刊論文

【摘要】：[目的]評(píng)價(jià)腕掌側(cè)入路加壓螺釘由腕舟狀骨近極向遠(yuǎn)極固定和由遠(yuǎn)極向近極固定對(duì)腕舟狀骨骨折患者骨折預(yù)后及功能恢復(fù)的臨床療效。[方法]采用腕掌側(cè)入路加壓螺釘治療48例腕舟狀骨骨折患者,均為跌傷,按手術(shù)方法不同分為兩組,近極向遠(yuǎn)極組:由腕舟狀骨近極向遠(yuǎn)極固定(23例),遠(yuǎn)極向近極組:由腕舟狀骨遠(yuǎn)極向近極固定(25例)。隨訪并比較兩組間骨折愈合時(shí)間、愈合率及腕關(guān)節(jié)功能Cooney評(píng)分和DASH問(wèn)卷調(diào)查表結(jié)果。[結(jié)果]近極向遠(yuǎn)極組有20例獲得骨性愈合,愈合率86.9%,平均愈合時(shí)間(10.52±2.85)周,遠(yuǎn)極向近極組有19例獲得骨性愈合,愈合率76%,平均愈合時(shí)間(14.31±1.98)周,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。Cooney評(píng)分結(jié)果:近極向遠(yuǎn)極組:優(yōu)11例,良7例,中1例,差1例,優(yōu)良率78.26%;遠(yuǎn)極向近極組:優(yōu)9例,良4例,中2例,差4例,優(yōu)良率52%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。DASH問(wèn)卷調(diào)查表評(píng)分:近極向遠(yuǎn)極組平均值(7.32±1.28)分,低于遠(yuǎn)極向近極組的(9.58±3.24)分,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。[結(jié)論]腕掌側(cè)入路加壓螺釘采用由近極向遠(yuǎn)極固定的方法能夠較好地保護(hù)腕舟狀骨血供,比由遠(yuǎn)極向近極固定更有效地促進(jìn)骨折愈合及術(shù)后腕關(guān)節(jié)功能的恢復(fù)。
[Abstract]:[objective] to evaluate the clinical effect of compression screw fixation from proximal pole to distal pole of scaphoid bone and distal pole fixation on the prognosis and functional recovery of carpal scaphoid fractures. [methods]. Treatment of 48 cases of Carpal scaphoid fracture with Compression Screw, According to the different surgical methods, they were divided into two groups: the proximal pole group: 23 cases were fixed from the carpal scaphoid bone to the distal pole, and the distal pole group: 25 cases were fixed from the carpal scaphoid bone to the proximal pole. The time of fracture healing between the two groups was compared and followed up. The healing rate and Cooney score of wrist joint function and the results of DASH questionnaire. [results] the bone healing rate was 86.9 in the near polar distal group, and the average healing time was 10.52 鹵2.85 weeks. 19 patients in the far polar proximal pole group got bone healing, and the average healing time was 10.52 鹵2.85 weeks. The healing rate was 76 and the average healing time was 14.31 鹵1.98 weeks. The difference between the two groups was statistically significant (P 0.05). Cooney score: 11 cases were excellent, 7 cases were good, 1 case was fair, 1 case was poor, the excellent and good rate was 78.26% in the near polar group, 9 cases were excellent, 4 cases were good, 2 cases were middle in the near polar group. 4 cases were poor, the excellent and good rate was 52%. The difference between the two groups was statistically significant (P 0.05) .DASH questionnaire score: the average value of the near polar group was 7.32 鹵1.28), which was lower than that of the far pole group (9.58 鹵3.24). The difference was statistically significant (P 0.05). [conclusion] the method of proximal pole to distal fixation can protect the blood supply of carpal scaphoid bone. It is more effective to promote fracture healing and wrist function recovery than distal to proximal fixation.
【作者單位】： 南通大學(xué)附屬吳江醫(yī)院蘇州市吳江區(qū)第一人民醫(yī)院;上海交通大學(xué)附屬第六人民醫(yī)院;
【基金】：蘇州市科技局項(xiàng)目(編號(hào):SYS201502)
【分類號(hào)】：R687.3

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