河北医科大学学报

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经桡骨茎突月骨周围骨折伴脱位微创治疗的临床研究

  

  1. 河北医科大学第三医院手外科,河北 石家庄 050051
  • 出版日期:2019-03-25 发布日期:2019-03-20
  • 作者简介:马学林(1990-),男,河北沧州人;河北医科大学第三医院医学硕士研究生,从事手外科疾病诊治研究。

Clinical research of minimally invasive treatment for transradial styloid perilunatefracturedislocations of the carpus

  1. Department of Hand Surgery, the Third Hospital of Hebei Medical University,  Shijiazhuang 050051, China
  • Online:2019-03-25 Published:2019-03-20

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗介绍一种特殊类型的腕关节损伤——经桡骨茎突月骨周围骨折伴脱位的微创手术方法并评价其疗效。
〖HTH〗方法〖HTSS〗〖KG*2〗6例经桡骨茎突月骨周围骨折伴脱位患者,采用C形臂引导下牵拉撬拨复位,经皮克氏针固定腕骨,结合小切口微型锚钉修复韧带的手术方法治疗。术后石膏牢靠固定,早期辅以功能练习。随访阶段均给予腕关节X线及电子计算机断层扫描(computed tomography,CT)检查评价,并利用腕关节Cooney评分评价术后腕关节恢复效果。
〖HTH〗结果〖HTSS〗〖KG*2〗所有患者无腕骨无菌性坏死、腕关节创伤性关节炎、腕关节不稳,腕关节的活动度均较术前有了明显提高,差异有统计学意义(P<005)。患侧/健侧握力恢复到76%~93%,平均(85.0±7.8)%,桡骨茎突骨折愈合时间6~8周,平均(6.7±0.6)周,随访时腕关节Cooney评分达到良及以上5例,患者满意。
〖HTH〗结论〖HTSS〗〖KG*2〗该微创方法是治疗经桡骨茎突月骨周围骨折伴脱位的一种可靠、安全、有效的手术方式。

关键词: 月骨, 桡骨茎突, 骨折, 脱位, 锚钉

Abstract: [Abstract] Objective〖HTSS〗〓To introduce minimally invasive surgery for a special type of wrist injury, transradial styloid perilunate fracturedislocations of the carpus, and evaluate its curative effect.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Six cases of transradial styloid perilunate fracturedislocations were treated under the Carm, Kirschner wire poking reset, and percutaneous Kirschner wire fixation, ligaments were repaired by miniature anchor under the small incision. Short arm plaster fixation after operation and assisted with functional exercises. Xray and computed tomography(CT) evaluation were given during the followup period, and the wrist function was evaluated with Cooney scoring method.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓There were no aseptic necrosis of carpus, traumatic arthritis of wrist and carpal instability in all 6 cases.The range of motion of wrist joint was significantly improved compared with that before operation, and the difference was statistically significant(P<005). The grip strength of affected side/healthy side recovered to 76%-93%, average(85.0±7.8)%. The healing time of radial styloid fracture ranged from 6 to 8 weeks, average(6.7±0.6) weeks.During followup, Cooney score of wrist joint reached good or above in 5 cases, and the patients were satisfied.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓This kind of minimally invasive treatment is a secure, safe and effective method for the treatment of transradial styloid perilunate fracturedislocations. 

Key words: lunate bone, styloid process of radius, fractures, bone, dislocations, anchor nail