两种不同手术入治疗腕舟骨骨折的临床研究.pdfVIP

Clinical Study on Treating Fracture of Scaphoid Bone with Two Different Surgical Approachs Speciality:Orthopaedics of TCM Author:Wang Guozong Tutor:Wang Mingxi Abstract Objective:To analyze the clinic outcome of the fracture of scaphoid bone treated with wrist palmar approach and wrist radial approach.Method:The patients were treated with Kirschner′s pin.The patients of old fracture were transplanted with bone.Fifty patients were followed up after operation.Twenty-seven of them were treated with wrist palmar approach.The others were treated with wrist radial approach.According to Jiranek grade and healing standard of fracture,comparisons of two different surgical approachs were implemented. Results:All were followed up for over eight months.Twenty-six patients healed when treated with wrist palmar approach.Eighteen patients healed when treated with wrist radial approach.There was no remarkable difference in Jiranek grade and healing condition.Conclusions:There is no remarkable difference between the wrist palmar approach and the wrist radial approach when the fracture of scaphoid bone is cured with Kirschner′s pin and bone transplanting if necessary. Key words Kirschner′s pin；fracture of scaphoid bone；wrist palmar approach ； wrist radial approach 目 录 引 言 1 临床研究 2 一、临床资料 2 （一）病例来源 2 （二）采集时间 2 （三）病例选择 2 （四）一般资料 2 二、治疗方法 3 （一）腕掌侧入路 3 （二）腕桡侧入路 3 （三）术后处理 3 三、疗效观察 3 （一）随访及评估方法 3 （二）统计方法 5 四、研究结果 5 （一）骨折的骨性愈合标准 5 （二）JIRANEK 腕舟骨骨折疗效标准评价 6 讨 论 7 一、中医“伤骨”理论 7 二、腕舟骨骨折的损伤机制 7 三、腕舟骨的应用解剖 8 四、腕舟骨骨折切开复位手术入路选择存在的争议 8 五、腕舟骨的血液供应 9 六、腕舟骨骨折治疗效果的分析 10 七、治疗方法的进一步探讨 11 结 语 13 参考文献 14 综 述 17 附 录 26