Clinical research of different nailing methods of hollow screw internal fixation in treating fresh carpal scaphoid fracture

ZHAO Wen; LIN Yan-shui; JIANG Tao; HE Jun; XIANG Deng; LIN Yang-jing; LIU Jin-wang; YU Hua

doi:10.3969/j.issn.1009-4237.2018.04.007

Abstract：Objective To compare the clinical efficacy of different nailing methods of hollow screw internal fixation(HSIF)in treating fresh carpal scaphoid fracture(SF).Methods A total of 78 patients with fresh SF treated by HSIF from Jul.2013 to Jun.2015 in our hospital were selected and divided into experimental group 1 and experimental group 2 according to the random number table method,with 39 cases in each group.Among them 48 were male and 30 were female with an average age of 39.77(17-50)years.Thirty-two cases were injured from falling,30 were injured from road traffic accidents,13 were from sports injury and 3 were from other reasons.Pa-tients in experimental group 1 were performed proximal-pole to distal-pole HSIF,and those in experimental group 2 were performed distal-pole to proximal-pole HSIF.The fracture healing state,work recovery time,carpal joint motion state 6 months before and after the operation and Cooney wrist joint scores 6 months after the operation of the two groups were observed.Results The fracture healing rate(89.74%)in experimental group 1 was higher than that in experimental group 2(74.36%),and the fracture healing time and work recovery time((9.89 ±1.17)weeks, (11.27 ±1.38)weeks)were less than those in experimental group 2((13.76 ±1.68)weeks,(15.92 ±1.85) weeks,P<0.05).After operation,the indexes of carpal joint motion in experimental group 1 were larger than those in experimental group 2(P<0.05).Each item's score and aggregate score of Cooney wrist joint in experimental group 1 were higher than those in experimental group 2(P<0.05).The excellent and good rate in experimental group 1(92.31%)was higher than that in experimental group 2(76.92%,P<0.05).Conclusion Proximal-pole to distal-pole HSIF in treating patients with fresh SF can effectively protect local blood supply,promote bony u-nion and improve wrist joint function,and the curative effect is significant.