关键词: 舟状骨骨折, 切开复位克氏针内固定术, Herbert螺钉内固定术, 腕关节, 疗效比较

Abstract: Objective  To explore and compare the efficacy of open reduction Kirschner-wire internal fixation and closed reduction Herbert screw internal fixation in the treatment of fresh unstable scaphoid lumbar fracture. Methods 72 patients with fresh unstable scaphoid lumbar fracture admitted to our hospital from January 2020 to January 2022 were selected and randomly divided into the experimental group(36 cases,open reduction Kirschberg wire internal fixation) and the control group(36 cases,closed reduction Herbert screw internal fixation).The operation time,fracture healing time,healing rate at 12 weeks,complication rate,scaphoid osteonecrosis rate,wrist functional recovery 6 months and 1 year after surgery were observed and compared within 2 groups,including wrist range of motion,improved Mayo wrist function score,pain index using visual analog scale(VAS).Results There were no significant differences in operation time,fracture healing time,healing rate and complication rate in 2 groups(P>0.05).6 months after surgery,the wrist motion of ulnar deviation,radial deviation,dorsalis extension and palmaris flexion in 2 groups were significantly improved compared with before surgery(P＜0.05).There was no significant difference in wrist motion in 2 groups after surgery(P＞0.05).Compared with 6 months after surgery,Mayo score of experimental group was significantly improved at 12 months after surgery(95.36±3.34) vs.(78.52±5.62)(P＜0.05),and VAS was significantly decreased(1.04±2.24) vs.(3.25±1.62)(P＜0.05),but there was no significant difference in Mayo score and VAS between 2 groups(P＞0.05).Conclusions Compared with closed reduction and Herbert screw internal fixation,open reduction and Kirschner wire internal fixation can also achieve satisfactory results.However,the operation cost and difficulty of Kirschner wire internal fixation are relatively low.

Key words: scaphoid fracture, open reduction Kirschner wire internal fixation, Herbert screw internal fixation, wrist joint, comparison of efficacy