摘要
目的探讨背侧入路与掌侧入路微创加压螺钉内固定治疗腕舟骨骨折的临床效果及安全性。方法选择2015年1月~2017年8月华北石油管理局总医院收治的80例腕舟骨骨折患者,按随机数字表法将其分为背侧入路组(n = 40)和掌侧入路组(n = 40)。背侧入路组给予背侧入路微创加压螺钉内固定治疗,掌侧入路组给予掌侧入路微创加压螺钉内固定治疗,术后随访1年。评价并比较两组临床疗效;比较两组术前、术后6个月、术后1年的视觉模拟评分(VAS);比较两组术中出血量和骨折愈合时间;记录并比较两组随访期间并发症发生情况。结果掌侧入路组临床疗效的优良率明显高于背侧入路组,差异有统计学意义(P < 0.05)。两组术后6个月、术后1年的VAS评分均较术前明显减小,且掌侧入路组术后6个月、术后1年的VAS评分均明显小于背侧入路组(P < 0.05)。掌侧入路组的术中出血量和骨折愈合时间均明显比背侧入路组少,差异有统计学意义(P < 0.05)。掌侧入路组的并发症发生率明显低于背侧入路组,差异有统计学意义(P < 0.05)。结论与背侧入路比较,掌侧入路微创加压螺钉内固定治疗腕舟骨骨折的临床效果更为明显,其能缩短骨折愈合时间,减轻疼痛,且安全性较好。
Objective To investigate the clinical efficacy and safety of minimally invasive compression screw internal fixation through dorsal and volar approaches in the treatment of scaphoid fracture. Methods Eighty patients with scaphoid fracture admitted to the General Hospital of North China Petroleum Administration from January 2015 to August 2017 were randomly divided into dorsal approach group (n = 40) and volar approach group (n = 40). The dorsal approach group was treated with minimally invasive compression screw internal fixation through the dorsal approach, and the volar approach group was treated with minimally invasive compression screw internal fixation through the volar approach. The follow-up period was 1 year. The clinical efficacy of the two groups was evaluated and compared. The visual analogue scores (VAS) of the two groups before operation, 6 months after operation and 1 year after operation were compared. The intraoperative blood loss and fracture healing time were compared. The complications of the two groups during the follow-up period were recorded and compared. Results The excellent rate of clinical effect in volar approach group was significantly higher than that in dorsal approach group (P < 0.05). The VAS scores of the two groups at 6 months and 1 year after operation were significantly lower than those before operation, and the VAS scores of the volar approach group at 6 months and 1 year after operation were significantly lower than those of the dorsal approach group (P < 0.05). The bleeding volume and fracture healing time of volar approach group were significantly less than those of dorsal approach group (P < 0.05). The incidence of complications in volar approach group was significantly lower than that in dorsal approach group (P < 0.05). Conclusion Compared with the dorsal approach, the volar approach with minimally invasive compression screw internal fixation for carpal scaphoid fracture has more obvious clinical effect, which can shorten the healing time of fracture, reduce pain, and has better safety.
作者
董红
何杨
张平方
张辉
王建民
赵宇宙
DONG Hong;HE Yang;ZHANG Pingfang;ZHANG Hui;WANG Jianmin;ZHAO Yuzhou(The First Department of Orthopaedics, General Hospital of North China Petroleum Administration, Hebei Province, Renqiu 062552, China)
出处
《中国医药导报》
CAS
2019年第15期69-72,共4页
China Medical Herald
基金
河北省医学科学研究重点课题计划(20150963)
关键词
腕舟骨骨折
背侧入路
掌侧入路
微创
加压螺钉
疗效
安全性
Scaphoid fracture
Dorsal approach
Volar approach
Minimally invasive
Compression screw
Efficacy
Safety
