摘要
目的评价手术治疗急性期经舟骨月骨周围背侧脱位的疗效。方法 2004年2月至2008年2月对13例患者在伤后1周内行经舟骨月骨周围背侧脱位切开复位内固定术,男9例,女4例;年龄25～53岁,平均42.3岁。术后按照Mayo腕关节评分、DASH评分评价随访时患者的临床疗效。同时术后拍摄标准腕关节正侧位片,观察舟月角及桡月角的改变,以及有无关节炎、缺血性坏死等表现。结果术后随访时间13～26个月,平均18个月。末次随访时平均DASH评分为9.3分,Mayo评分结果为优2例,良7例,可3例,差1例。伤腕平均屈伸活动为98°,伤腕的平均握力相当于健侧的73%,平均舟月角为53.7°,平均桡月角为5.2°。2例患者末次随访时出现关节炎。结论切开复位内固定术能有效的恢复各腕骨的解剖位置,实现坚强内固定,从而极大的改善患者的疼痛、手腕活动度及握力,其治疗经舟骨月骨周围背侧脱位临床疗效显著。
Objective To evaluate the clinical effects of open operation on patients with transscaphoid perilunate fracture-dislocation in acute phase.Methods From February 2004 to February 2008,13 cases with transscaphoid perilunate fracture-dislocations in acute phase were treated by open operation.Those 13 cases（9 males and 4 females） range from 25 to 53 years old with an average of 42.3 years.All patients were given X-ray examination in PA view, lateral view after operation and were assessed by Mayo wrist score,The disabilities of the arm,houlder and hand （DASH） outcome questionnaire,scapholunate angle,radiolunate angle,arthritis and ischemic necrosis.Results The patients were followed up for 13 to 26 months with a mean period of 18 months.According to the Mayo wrist score at the final assessit was excellent in 2 cases,good in 7,fair in 3 and poor in 1.At the final assessit,the mean DASH was 9.3.The average range of motion（flexion and extension） was 98 degrees and grip strength loss 37%in comparison with the contralateral wrist.And the average scapholunate angle was 53.7 degrees and the radiolunate angle was 5.2 degrees.2 patient was found Arthritis at the last follow-up.Conclusion The open operation and internal fixation is able to restore and fix the anatomical position of the carpal bone effectively,as well as release patients’ pain and impove range of motion and grip strength,which indicates that it is a effective method to treat transscaphoid perilunate fracture-dislocations.
出处
《实用骨科杂志》
2011年第9期792-795,共4页
Journal of Practical Orthopaedics
关键词
月骨脱位
腕骨骨折
外科手术
lunate dislocation
wrist fracture
surgery
