目的 探讨关节镜辅助下空心螺钉固定治疗新鲜腕舟骨骨折的疗效。方法 2022年5月—2023年2月，采用关节镜辅助下空心螺钉固定治疗30例腕舟骨骨折患者。男15例，女15例；年龄22～64岁，平均44.1岁。致伤原因：运动伤9例，交通事故伤9例，跌倒伤12例。骨折根据Herbert分型标准为B1型9例、B2型21例，均未合并三角纤维软骨复合体及韧带损伤。受伤至手术时间2～14 d，平均6.0 d。记录手术时间、术中出血量以及并发症发生情况。影像学复查骨折愈合情况，12个月时行改良Mayo腕关节评分及Herbert和Fisher腕舟骨骨折评价，测量腕关节主动屈、伸及桡偏、尺偏活动度并与健侧进行比较。结果 手术时间40～65 min，平均53.5 min；术中出血量5～20 mL，平均11.2 mL。患者均获随访，随访时间12～15个月，平均13.3个月。术后切口均Ⅰ期愈合，未出现感染、神经血管损伤等并发症。影像学复查示术后6个月时骨折均达骨性愈合，随访期间未出现螺钉松动等并发症。术后12个月，改良Mayo腕关节评分达优27例、良3例；Herbert和Fisher腕舟骨骨折评价达0级27例、1级3例；患侧腕关节主动屈、伸、桡偏、尺偏活动度均小于健侧，差异有统计学意义（P<0.05）。结论 关节镜辅助下空心螺钉固定具有微创、精确复位及快速康复的优势，是治疗新鲜腕舟骨骨折有效方法。
Citation：
栗宝鹏, 杜东鹏, 罗文婧, 袁重玺, 刘裔阳, 顾明浩, 赵涛. 关节镜辅助下空心螺钉固定治疗新鲜腕舟骨骨折. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(1): 126-128. doi: 10.7507/1002-1892.202409096
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- 1. 王大伟, 程保国, 解琛, 等. 腕舟骨骨折不愈合的研究进展. 中华手外科杂志, 2024, 40(2): 190-192.
- 2. Chambers SB, Padmore CE, Grewal R, et al. The impact of scaphoid malunion on radioscaphoid joint contact: A computational analysis. J Hand Surg (Am), 2020, 45(7): 610-618. e1.
- 3. Phillips R, Choo S, Fletcher B, et al. Dry wrist arthroscopy: Technique and rationale. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2023, 39(8): 1779-1780.
- 4. Özden F. Comparison of conservative treatment and surgery treatment for acute scaphoid fracture: A meta-analysis of randomized controlled trials. World J Surg, 2023, 47(12): 3449-3450.
- 5. Beck A. The incidence of scapholunate ligament disruption in competitive divers. British Journal of Sports Medicine, 2020, 54(Suppl 1): A51.
- 6. 刘司达, 韩峰, 蒋华军, 等. 舟月韧带损伤的诊治进展. 中华手外科杂志, 2021, 37(5): 396-400. doi: 10.3760/cma.j.cn311653-20210223-00065.
