| 切开复位内、外固定结合锚钉修复腕骨间韧带治疗月骨周围损伤 |
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投稿时间：2017-12-28 修订日期：2018-09-06
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| 期刊信息：《中国骨伤》年，第卷，第期，第-页 |
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| 中文摘要:【】 目的： 探讨切开复位内、外联合固定结合锚钉修复腕骨间韧带治疗月骨周围损伤的可行性、技术要点及临床效果。方法：2012年9月至2016年9月,采用克氏针行腕骨间关节固定,3.0mm空心钉固定舟骨骨折,可吸收锚钉修复腕骨间韧带,联合跨腕关节支架固定治疗月骨周围损伤患者11例,男7例,女4例；年龄29～68岁,平均43.6岁。其中经舟骨骨折月骨周围脱位5例,月骨周围脱位6例,观察结果包括舟月角、桡月角、腕骨高度指数、腕关节活动度等。结果：所有患者伤口Ⅰ期愈合,术后随访时间为10~24月,平均16.3月。X线 |
| 【关键词】舟骨 月骨周围脱位 骨折固定术 舟月角 桡月角 |
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| Internal and external fixation after open reduction combined with intercarpal ligament repair for the treatment of perilunate injuryTANG Chun-hui, YAO Gao-wen, WANG Lin,LUO Wei Department of Orthopaedics, The First People’s Hospital of Nei Jiang City, Neijiang 641000, Si Chuan, China |
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| ABSTRACT ABSTRACT Objective: To evaluate the feasibility of internal and external fixation after open reduction combined with suture anchors to repair the intercarpal ligaments for the treatment of perilunate injury, and to explore its operative techniques and
therapeutic efficacy. Methods: From September 2012 to September 2016, 11 patients with perilunate injury were surgically treated with K-wire in intercarpal articulations, 3.0 mm cannulated screws for scaphoid fracture, absorbable anchor for intercarpal ligament repair, together with fixators at intercarpal joints, among whom 6 suffered from perilunate dislocations and 5 from transscaphoid fracture dislocations. There were 7 males and 4 females with an average age of 42.6 years ranging from 29 to 68 years. Scapho-lunate angle, radio-lunate angle, index of carpal height and ROM of the wrist were observed. Results: All wounds were healed at stage Ⅰ. 11 patients were followed up in a period varying from 10 to 24 months with an average of 16.3 months. The height of the carpal was maintained well with a mean scapho-lunate angle of 51°(35°~65°), mean radio-lunate angle of 7°(-10°~15°), and mean index of carpal height being 0.51(0.50~0.53). Necrosis of lunate and scaphoid was not observed. The ROM of the wrist averages about 91.5°.The grip strength was recovered and amounted to 78.5% of that of the contralateral side. Among the 11 patients, 6 reported no feeling of pain, 3 mild feeling of pain, and 2 medium level of pain. According to Cooney wrist score, 8 cases were considered excellent, 2 good and 1 fair,with an average score of 85.27±9.55. Conclusion: The wrist functions can be obtained satisfactorily by intervening in the early stage through internal and external fixation after open reduction combined with suture anchors to repair intercarpal ligaments for the treatment of perilunate injury. It has advantages of shorter operation time, smaller invasive trauma, less blood loss and etc. Therefore, this technique is safe and practicable, yielding satisfying clinic effects. |
| KEY WORDS Scaphoid Perilunate dislocation Fracture fixation Scapho-lunate angle Radio-lunate angle |
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