应用AO加压空心螺钉治疗新鲜腕骨骨折

摘要

目的 报道应用AO加压空心螺钉内固定治疗新鲜腕骨骨折的手术方法和临床疗效.方法 2009年1月-2015年6月,对30例新鲜腕骨骨折患者采用AO加压空心螺钉内固定治疗.结果 术后随访6~30个月,平均14个月.其中28例腕骨骨折Ⅰ期愈合,腕关节活动范围:掌屈20°~60°,背伸15°~55°,桡偏10°~25°,尺偏15°~40°,旋前50°~70°,旋后45°~75°;腕部握力平均恢复至健侧的85%.2例舟骨不愈合,骨折端硬化,腕关节活动功能障碍,鼻烟窝有明显压痛,Ⅱ期行移植髂骨植骨术,骨折顺利愈合.30例均无伤口感染及骨髓炎发生,内固定拆除时间为3~24个月,平均4.5个月,无创伤性关节炎发生,未发生螺钉断裂现象.结论 AO加压空心螺钉治疗腕骨骨折,既恢复了腕骨的解剖关系,维持腕骨间关节的稳定性,又可以早期活动,减少腕部疼痛等并发症的出现.%Objective To report the fresh surgical method and clinical efficacy of application AO hollow compression screw internal fixation in treatment of carpal bone fractures. Methods From January 2009 to June 2015, 30 patients with fresh carpal bone fractures were treated by internal fixation with AO compression hollow screws. Results Postoperative followed-up 6~30 months, for average of 14 months, 28 cases with carpal bone fracture primary healed, wrist range: palm down 20° ~ 60°, back stretch 15° ~55°, radial partial 10° ~ 25°, ulnar deviation 15° ~ 40°, pronation 50° ~ 70°, supination 45° ~ 75°. 85% of the average return to the contralateral wrist grip strength. 2 cases with fracture of scaphoid nonunion, hardening, wrist joint dysfunction, snuff nest had obvious tenderness, transplanting iliac bone graft in second stage and bone fracture healed smoothly. 30 cases had no wound infection and osteomyelitis, internal fixation removal time for 3~24 months, an average of 4.5 months, without the occurrence of traumatic arthritis, no screw fracture phenomenon happened. Conclusion By using AO compression hollow screws to treat carpal bone fracture, not only restore carpal bone anatomy relationship, and maintain the stability of the wrist joint, but also can early activity, reduce the occurrence of complications such as wrist pain.