摘要目的 探讨桡骨远端骨折合并舟骨骨折的治疗效果.方法 自2011年4月至2014年2月,我们共收治11例桡骨远端骨折合并舟骨骨折患者.桡骨远端骨折采用AO分型,舟骨骨折采用Herbert分型,AO/Herbert分型:B1/A2型1例,B3/B1型3例,C2/A2型4例,C2/B1型2例,C3/B2型1例.桡骨远端骨折采用掌侧切开复位钢板内固定治疗,随后舟骨骨折采用闭合复位无头加压空心螺钉(HCS)内固定治疗,其中1例术中行植骨术.术后1年采用Gartland-Werley系统评分及DASH评分进行功能评定.结果 术后患者切口均Ⅰ期愈合,无感染、骨不连、舟骨缺血坏死等发生.术后11例患者均获得随访,时间为12～18个月,平均15个月.桡骨远端骨折愈合时间为4～ 12个月,平均8个月;舟骨骨折愈合时间为4～ 10个月,平均6个月.术后1年随访腕关节主动背伸平均65°,掌屈55°;DASH评分平均12分;Gartland-Werley系统评分功能评定:优7例,良2例,可2例.结论 桡骨远端骨折合并舟骨骨折早期内固定治疗,手术操作简单,利于早期功能锻炼,疗效满意.

abstractsObjective To evaluate the clinical outcomes of treating distal radius fracture combined with scaphoid fracture with plate and Herbert cannulated screw fixation.Methods Eleven cases of combined distal radius and scaphoid fractures were treated between April 2011 and February 2014.AO classification and Herbert classification were used to categorize the distal radius fractures and scaphoid fractures,respectively.There were 1 case of type B1 / A2,3 cases of type B3 / B1,4 cases of type C2 / A2,2 cases of type C2 / B1,and1 case of type C3/B2.Distal radius fractures were managed with open reduction and plate fixation through a volar approach.Scaphoid fractures were treated simultaneously with closed reduction and cannulated Herbert screw fixation.Bone graft was necessary in one case.The patients were evaluated one year after the surgery using the Gartland-Werley scoring system and DASH questionnaire.Results Primary healing of the incisions was achieved in all cases.There were no infections,bone nonunion,or scaphoid avascular necrosis.The 11 patients were follow-up for 12 to 18 months postoperatively,with an average of 15 months.The healing time of distal radius fractures ranged from 4 to 12 months,the average being 8 months.The healing time of scaphoid fractures ranged from 4 to 10 months,with an average of 6 months.Wrist dorsiflexion averaged 65° and wrist flexion averaged 55° one year postoperatively.The average DASH score was 12 points.Wrist function was graded as excellent in 7 cases,good in 2 cases and fair in 2 cases according to Gartland-Werley scoring system.Conclusion Early internal fixation for combined distal radius and scaphoid fractures allows early postoperative rehabilitation and leads to satisfactory results.