| 任东,任方达,陈焱,等.锁定钛板内固定结合自体松质骨移植治疗腕舟骨骨不连的疗效分析.骨科,2025,16(3): 219-223. |
| 锁定钛板内固定结合自体松质骨移植治疗腕舟骨骨不连的疗效分析 |
| Locking compression plate fixation combined with autogenous cancellous bone graft in treatment of scaphoid nonunion |
| 投稿时间：2025-02-17 |
| DOI：10.3969/j.issn.1674-8573.2025.03.005 |
| 中文关键词: 腕舟骨 骨折不愈合 锁定钢板 自体骨移植 |
| 英文关键词: Scaphoid Nonunion Locking plate Autogenous bone graft |
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| 中文摘要: |
| 目的 探讨采用锁定钛板内固定结合自体松质骨移植治疗腕舟骨骨不连的临床疗效。方法 回顾性分析2019年10月至2021年10月武汉市第四医院收治的15例腕舟骨骨不连病人的临床资料，平均年龄34.9岁（17~71岁），男12例，女3例；右侧13例，左侧2例。病人入院后均采用掌侧锁定钛板内固定结合自体松质骨移植治疗。术后定期随访，通过影像学检查判断病人骨折愈合情况；测量病人腕关节屈伸及侧偏活动度，记录术前及末次随访时Mayo腕关节功能评分及上肢功能障碍（DASH）评分，采用疼痛视觉模拟量表（VAS）评分评估病人主观疼痛程度。结果 本组病例切口均一期愈合。15例病人平均随访时间为18.4个月（12~26个月）。所有骨折均获得骨性愈合，平均愈合时间为16.9周（8~32周）。末次随访，病人腕关节屈曲活动度由术前的30.33°±13.76°改善为48.67°±18.3°；腕关节背伸活动度由21.67°±15.49°改善为39.33°±16.17°；病人DASH评分由术前的（29.21±10.95）分改善为术后的（21.94±10.60）分；Mayo评分由术前（61.67±10.63）分提升为术后（76.33±10.26）分；VAS评分由术前（6.03±1.69）分改善为术后（2.21±1.08）分。以上结果差异均有统计学意义（P＜0.05）。结论 掌侧锁定钛板固定联合自体松质骨移植治疗腕舟骨骨不连具有较高的骨折愈合率，术后病人腕关节功能明显改善，腕关节疼痛明显缓解。 |
| 英文摘要: |
| Objective To explore the clinical effect of locking compression plate (LCP) fixation combined with autogenous cancellous bone graft in treatment of scaphoid nonunion. Methods The clinical data of 15 patients who were diagnosed as having scaphoid nonunion admitted at Wuhan Fourth Hospital from October 2019 to October 2021 were retrospectively analyzed, with average age of 34.9 (range 17-71) years old, including 12 males and 3 females. They were treated with LCP fixation and autogenous cancellous bone grafting. The patients were followed up regularly after surgery. Clinical assessments included time to union based on imageological examination, wrist range of motion (ROM), wrist function score (Mayo score), visual analogue scale (VAS) score and the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH questionnaire). Results The wound healed by first intention in 15 cases. All patients were followed up for average 18.4 months (range 12-26 months). Union was achieved in all patients. Bone union was obtained at an average of 16.9 weeks (range 8-32 weeks) after surgery. At the last follow-up, the patient's ROM of wrist flexion was improved from preoperative (30.33°±13.76°) to 48.67°±18.3°. The ROM of wrist extention was improved from 21.67°±15.49° to 39.33°±16.17°. DASH score was improved from 29.21±10.95 to 21.94±10.60. Mayo score increased from 61.67±10.63 to 76.33±10.26. VAS score decreased from 6.03±1.69 to 2.21±1.08. The difference in ROM, Mayo score, DASH questionnaire score and VAS score was statistically significant before and after operation (P＜0.05). Conclusion The LCP fixation in combination with autogenous cancellous bone transplantation has a good healing rate for the treatment of scaphoid nonunion, and the patient's postoperative wrist joint pain is significantly alleviated, with satisfactory recovery of wrist joint function. |
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