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目的通过尸体解剖研究,比较掌侧逆行与顺行螺钉放置技术对腕舟骨外周血运的破坏情况,从而为临床上置钉方式的选择提供解剖学依据。方法将5具新鲜冰冻尸体的上肢标本(共计10只),随机分为对照组(掌侧顺行螺钉放置技术)、试验组(掌侧逆行螺钉放置技术),每组5只,均按照各自手术方法完成模拟手术,经血管填充剂填充后进行局部解剖,观察并比较两组腕舟骨外周血运破坏情况。结果通过对5具新鲜冰冻尸体上肢标本的解剖学研究比较,试验组与对照组相比手术视野清晰,组织结构分辨清楚,血管填充剂渗出极少(P<0.05)。结论经掌侧逆行螺钉放置技术与经掌侧顺行螺钉放置技术相比,前者对腕舟骨外周血运破坏较小,可最大限度保护腕舟骨血运。
OBJECTIVE: To provide an anatomical basis for the choice of clinical approach to nailing by analyzing the results of autopsy study and comparing the disruption of peripheral blood supply to the scaphoid with the application of retrograde and antegrade screws. Methods Five fresh frozen cadaveric upper limbs (10 in total) were randomly divided into control group (metacarpopular parallel screw placement technique) and experimental group (metacarpal retrograde screw placement technique) Surgical methods to complete the simulation operation, filled with vascular fillers after local anatomy, observation and comparison of the two groups of scaphoid peripheral blood damage. Results Compared with the anatomical study of 5 fresh frozen cadaveric upper limbs, the visual field of the operation group was clear and the histological structure was clearly distinguished. The exudation of vascular filler was very little (P <0.05). Conclusions The technique of transplanting the palmar-lateral retrograde screw and the transplanting of the palmar-lateral transfixion screw have less damage to the peripheral blood of the scaphoid and can protect the carpus blood vessels to the maximum extent.