| 手法整复石膏外固定治疗经舟状骨骨折月骨周围脱位 |
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投稿时间：2018-02-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 张欣 |
ZHANG Xin |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 魏强 |
WEI Qiang |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
yesterdaywei@126.com |
| 纪方 |
JI Fang |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 佟大可 |
TONG Da-ke |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 唐昊 |
TANG Hao |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 章浩 |
ZHANG Hao |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 于金国 |
YU Jin-guo |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 杨继东 |
YANG Ji-dong |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 崔睿 |
CUI Rui |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 霍宁宁 |
HUO Ning-ning |
上海长海医院创伤骨科, 上海 200433 |
Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation ZHANG Xin, WEI Qiang, JI Fang, TONG Da-ke, TANG Hao, ZHANG Hao, YU Jin-guo, YANG Ji-dong, CUI Rui, and HUO Ning-ning |
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| 期刊信息：《中国骨伤》2018年，第31卷，第5期，第441-445页 |
| DOI：10.3969/j.issn.1003-0034.2018.05.009 |
| 基金项目: |
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中文摘要:
目的：探讨手法整复石膏外固定治疗经舟状骨骨折月骨周围脱位的疗效及并发症。
方法：回顾性分析自2009年1月至2013年1月期间经舟状骨骨折月骨周围脱位患者43例，其中17例（男10例，女7例）采取手法整复、石膏外固定治疗，为保守组；26例（男15例，女11例）采取手术治疗，为手术组。通过腕关节功能评分、影像学评价、并发症分析等方式评价疗效。
结果：43例患者获随访，时间36~60（45.00±8.72）个月。末次随访Cooney腕关节功能评分：保守组88.53±4.24，手术组89.58±4.59（t=0.455，P>0.05）。随访期内保守组4例患者出现舟状骨缺血性坏死的影像学表现（χ2=4.32，P<0.05）。两组并发症发生率比较，差异无统计学意义（P>0.05）。
结论：对于经舟状骨骨折月骨周围脱位患者，若能够在伤后尽早进行手法整复、石膏外固定，并维持满意的复位与可靠的固定，则治疗效果与手术治疗相比没有劣势，但有增加并发症的危险。保守治疗的关键在于尽可能早期诊断并维持复位，可靠的固定，以及适时、恰当的功能锻炼。 |
| 【关键词】舟骨 骨折 月骨 脱位 骨折闭合复位 外固定器 |
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| Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation |
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ABSTRACT
Objective: To investigate the efficacy and complications of manual reduction and external fixation for the treatment of scaphoid fractures and perilunate dislocations.
Methods: From January 2009 to January 2013, 43 patients suffered from scaphoid fractures and perilunate dislocations were retrospective analyzed. Among them, 17 cases were treated with manipulative reduction and plaster external fixation as conservation group including 10 males and 7 females, the other 26 cases were treated with application of surgical as operation group including 15 males and 11 females. The clinical effects were assessed by Cooney function score, radiological analysis and observation of complications.
Results: All patients were followed up for (45.00±8.72) months ranging from 36 to 60 months. At the final follow-up, the Cooney score of wrist function was 88.53±4.24 in conservation group and 89.58±4.59in operation group (t=0.455, P>0.05). During the follow-up, 4 patients were found scaphoid avascular necrosis in the imaging performance in the conservation group (χ2=4.32, P<0.05). The difference of other complications between two groups was not statistically significant (P>0.05).
Conclusion: For patients suffered from the scaphoid fractures and perilunate dislocation, the early manipulative reduction and plaster external fixation after injury as soon as possible is necessary. Maintaining a satisfactory reduction and reliable fixation at the same time can lead to good treatment effect and there's no weakness compared to surgical treatment. But there was an increase in danger of complications. The key of conservative treatment lies in early diagnosis and maintenance of reduction, reliable fixation, and timely and appropriate functional exercise. |
| KEY WORDS Scaphoid bone Fractures Lunate bone Dislocations Closed fracture reduction External fixators |
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| 中文格式: | 张欣,魏强,纪方,佟大可,唐昊,章浩,于金国,杨继东,崔睿,霍宁宁.手法整复石膏外固定治疗经舟状骨骨折月骨周围脱位[J].中国骨伤,2018,31(5):441~445 |
| 英文格式: | ZHANG Xin,WEI Qiang,JI Fang,TONG Da-ke,TANG Hao,ZHANG Hao,YU Jin-guo,YANG Ji-dong,CUI Rui,HUO Ning-ning.Manipulative reduction and plaster external fixation for the treatment of the scaphoid fracture and perilunate dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(5):441~445 |
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