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Early closed reduction combined with Herbert screw,Kirschner wire and mini suture anchors in the treatment of periosteal fracture and dislocation |
ZHANG Chuan-hui SUN Cheng-shuai |
Department of Orthopaedics,Chaoyang Center Hospital,Liaoning Province,Chaoyang 122000,China |
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Abstract Objective To investigate the clinical effect of early closed reduction combined with Herbert screw,Kirschner wire and anchor screw for the perilunate fracture and dislocation.Methods The clinical data of 37 patients with fresh perilunate fracture and dislocation in Chaoyang Center Hospital from January 2014 to may 2019 were retrospective analyzed.They were divided into the observation group(23 cases)and the control group(14 cases)according to the treatment method.In the observation group,closed reduction of fracture and dislocation in the early stage,all the fractures were fixed with hollow compression screw and/or Kirschner wire,and the mini suture anchors were performed to repair intercarpal ligament in a limited incision while the intercarpal joints were temporarily fixed with Kirschner wire.In the control group,patients were treated with closed reduction and Kirschner wire internal fixation and plaster cast external fixation.The differences of wrist function,wrist flexion and extension range of motion,fracture healing,complication(re-dislocation,nonunion and osteonecrosis)were compared between the two groups.Results The Cooney wrist function scores in the observation group was higher than that in control group,the difference was statistically significant(P<0.05).The healing time of fracture in observation group was shorter than that in control group,the difference was statistically significant(P<0.05).The range of wrist flexion and extension was larger than that in control group,the difference was statistically significant(P<0.05).And the total incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Early closed reduction combined with Herbert screw,Kirschner wire and repair of intercarpal ligament with mini suture anchors is a good treatment for fresh periosteal fracture and dislocation.It can effectively promote fracture healing,reduce the occurrence of complications,enable patients to obtain good wrist joint function,and prevent the occurrence of wrist instability.
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Received: 15 June 2020
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