Clinical application of nitinol memory alloy two foot fixator combined with Kirschner wire in treatment of trans-scaphoid perilunate dislocation_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XU Yujian ¹ ,  XU Yongqing ² , HE Xiaoqing ² , LI Chuan ² , YANG Xi ² , ZHANG Xulin ² , ZHAO Wanqiu ²

1. The Graduate School, Army Military Medical University, Chongqing, 400000, P.R.China;
2. Department of Orthopaedics, the 920th Hospital of Joint Logistics Support Force of Chinese PLA, Kunming Yunnan, 650032, P.R.China;

Corresponding author：

XU Yongqing, Email: xuyongqingkm@163.net

Keywords：

Trans-scaphoid perilunate dislocation; nitinol memory alloy two foot fixator; open reduction; internal fixation

DOI：

10.7507/1002-1892.201911013

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Objective To evaluate the effectiveness of nitinol memory alloy two foot fixator combined with Kirschner wire in the treatment of trans-scaphoid perilunate dislocation.Methods Between September 2011 and October 2018, 17 patients with trans-scaphoid perilunate dislocation were treated with nitinol memory alloy two foot fixator and Kirschner wire. There were 12 males and 5 females, with an average age of 32.6 years (range, 23-52 years). The disease duration was 8 hours to 9 days, with an average of 6.5 days. The causes of injury included 6 cases of falling injury, 4 cases of traffic accident injury, 3 cases of stress injury of wrist caused by sports, 2 cases of violent injury of wrist caused by machine impact, 1 case of military training injury, and 1 case of other injury. One case was complicated with nerve injury. According to Herbert’s classification, all the fractures were type B4. At 1 week before operation, 3 months, 6 months after operation and last follow-up, the wrist function was evaluated according to the Krimmer scale score.Results All the 17 patients were followed up 10.5-48 months, with an average of 18.6 months. There was no loosening or infection of the internal fixator, no necrosis of the scaphoid and lunate. The periosteal dislocations of the patients were well reduced and the scaphoid fractures all healed. The healing time was 4-18 months, with an average of 11.3 months. The Krimmer wrist scores were 37.5±4.4, 61.3±7.2, 83.3±9.3, 87.3±8.2 at 1 week before operation, 3 months, 6 months after operation and last follow-up, respectively. The Krimmer wrist score at each time point after operation was significantly improved when compared with that before operation (P<0.05), and at 6 months after operation and last follow-up than at 3 months after operation (P<0.05). There was no significant difference between at 6 months and last follow-up (P>0.05). At last follow-up, the Krimmer wrist function was excellent in 13 cases, good in 2 cases, fair in 1 case, poor in 1 case, and the excellent and good rate was 88.23%.Conclusion Nitinol memory alloy two foot fixator combined with Kirschner wire in the treatment of trans-scaphoid periosteal dislocation has definite effectiveness, simple operation, and good recovery of wrist function after operation.

Citation： XU Yujian, XU Yongqing, HE Xiaoqing, LI Chuan, YANG Xi, ZHANG Xulin, ZHAO Wanqiu. Clinical application of nitinol memory alloy two foot fixator combined with Kirschner wire in treatment of trans-scaphoid perilunate dislocation. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(6): 671-675. doi: 10.7507/1002-1892.201911013 Copy

1.	Drac P, Cizmar I, Manak P, et al. Comparison of the results and complications of palmar and dorsal miniinvasive approaches in the surgery of scaphoid fractures. A prospective randomized study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2014, 158(2): 277-281.
2.	Kim JP, Lee JS, Park MJ. Arthroscopic reduction and percutaneous fixation of perilunate dislocations and fracture-dislocations. Arthroscopy, 2012, 28(2): 196-203.
3.	王孝辉, 王庆丰, 张彩丽. 超声引导下经皮 Herbert 螺钉治疗新鲜无移位腕舟骨骨折. 中国修复重建外科杂志, 2018, 32(8): 989-992.
4.	杨晨光, 陈亮, 胡韶楠. 急性腕舟骨骨折的诊断治疗研究进展. 中国修复重建外科杂志, 2019, 33(4): 507-510.
5.	Kremer T, Wendt M, Riedel K, et al. Open reduction for perilunate injuries—clinical outcome and patient satisfaction. J Hand Surg (Am), 2010, 35(10): 1599-1606.
6.	Varga P, Zysset PK, Schefzig P, et al. A finite element analysis of two novel screw designs for scaphoid waist fractures. Med Eng Phys, 2016, 38(2): 131-139.
7.	牛升波, 曹学成. 切开复位内固定治疗急性经舟骨月骨周围脱位. 中医正骨, 2015, 27(4): 59-61.
8.	Çolak I, Bekler HI, Bulut G, et al. Lack of experience is a significant factor in the missed diagnosis of perilunate fracture dislocation or isolated dislocation. Acta Orthop Traumatol Turc, 2018, 52(1): 32-36.
9.	周炎, 刘世清, 余铃, 等. 经三关节克氏针固定结合骨锚修复治疗急性期月骨周围损伤. 中国修复重建外科杂志, 2014, 28(9): 1086-1090.
10.	贾晶, 赵玲珑, 石宇. 切开复位无头空心加压螺钉固定结合腕骨间韧带修复治疗新鲜经舟骨月骨周围脱位. 中国骨与关节损伤杂志, 2015, 30(7): 772-773.
11.	Apergis E. Acute perilunate dislocations and fracture dislocations//Apergis E, ed. Fracture Dislocations of the Wrist. Italia: Springer-Verlag, 2013: 61-137.
12.	徐辉豪, 黄俊伍. Herbert 螺钉内固定和石膏外固定治疗腕舟骨稳定型骨折的比较研究. 中华手外科杂志, 2016, 32(2): 85-86.
13.	徐达传, 黄美贤. 手舟骨的形态血供特点及其临床意义. 中华关节外科杂志 (电子版), 2010, 4(2): 251-255.
14.	孔维云, 徐永清, 王宇飞, 等. 镍钛记忆合金腕舟骨内固定器的研制及生物力学测试. 中国修复重建外科杂志, 2008, 22(1): 48-52.
15.	张旭林, 徐永清, 何晓清. 手舟骨腰部骨折 3 种内固定方式的有限元分析. 中国临床解剖学杂志, 2019, 37(5): 553-558.
16.	曾俊, 林旭, 钟泽莅, 等. 个体化经皮空心螺钉内固定治疗 Herbert Ⅰb 型腕舟骨骨折临床研究. 中国修复重建外科杂志, 2016, 30(10): 1189-1194.
17.	董丰乐, 冯卫华. 外固定支架联合空心螺钉克氏针内固定治疗经舟骨月骨周围脱位的效果. 社区医学杂志, 2018, 16(2): 31-32.
18.	张立国. 经舟骨月骨周围脱位治疗 11 例临床分析. 世界最新医学信息文摘, 2019, 19(44): 103-105.

1. Drac P, Cizmar I, Manak P, et al. Comparison of the results and complications of palmar and dorsal miniinvasive approaches in the surgery of scaphoid fractures. A prospective randomized study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2014, 158(2): 277-281.
2. Kim JP, Lee JS, Park MJ. Arthroscopic reduction and percutaneous fixation of perilunate dislocations and fracture-dislocations. Arthroscopy, 2012, 28(2): 196-203.
3. 王孝辉, 王庆丰, 张彩丽. 超声引导下经皮 Herbert 螺钉治疗新鲜无移位腕舟骨骨折. 中国修复重建外科杂志, 2018, 32(8): 989-992.
4. 杨晨光, 陈亮, 胡韶楠. 急性腕舟骨骨折的诊断治疗研究进展. 中国修复重建外科杂志, 2019, 33(4): 507-510.
5. Kremer T, Wendt M, Riedel K, et al. Open reduction for perilunate injuries—clinical outcome and patient satisfaction. J Hand Surg (Am), 2010, 35(10): 1599-1606.
6. Varga P, Zysset PK, Schefzig P, et al. A finite element analysis of two novel screw designs for scaphoid waist fractures. Med Eng Phys, 2016, 38(2): 131-139.
7. 牛升波, 曹学成. 切开复位内固定治疗急性经舟骨月骨周围脱位. 中医正骨, 2015, 27(4): 59-61.
8. Çolak I, Bekler HI, Bulut G, et al. Lack of experience is a significant factor in the missed diagnosis of perilunate fracture dislocation or isolated dislocation. Acta Orthop Traumatol Turc, 2018, 52(1): 32-36.
9. 周炎, 刘世清, 余铃, 等. 经三关节克氏针固定结合骨锚修复治疗急性期月骨周围损伤. 中国修复重建外科杂志, 2014, 28(9): 1086-1090.
10. 贾晶, 赵玲珑, 石宇. 切开复位无头空心加压螺钉固定结合腕骨间韧带修复治疗新鲜经舟骨月骨周围脱位. 中国骨与关节损伤杂志, 2015, 30(7): 772-773.
11. Apergis E. Acute perilunate dislocations and fracture dislocations//Apergis E, ed. Fracture Dislocations of the Wrist. Italia: Springer-Verlag, 2013: 61-137.
12. 徐辉豪, 黄俊伍. Herbert 螺钉内固定和石膏外固定治疗腕舟骨稳定型骨折的比较研究. 中华手外科杂志, 2016, 32(2): 85-86.
13. 徐达传, 黄美贤. 手舟骨的形态血供特点及其临床意义. 中华关节外科杂志 (电子版), 2010, 4(2): 251-255.
14. 孔维云, 徐永清, 王宇飞, 等. 镍钛记忆合金腕舟骨内固定器的研制及生物力学测试. 中国修复重建外科杂志, 2008, 22(1): 48-52.
15. 张旭林, 徐永清, 何晓清. 手舟骨腰部骨折 3 种内固定方式的有限元分析. 中国临床解剖学杂志, 2019, 37(5): 553-558.
16. 曾俊, 林旭, 钟泽莅, 等. 个体化经皮空心螺钉内固定治疗 Herbert Ⅰb 型腕舟骨骨折临床研究. 中国修复重建外科杂志, 2016, 30(10): 1189-1194.
17. 董丰乐, 冯卫华. 外固定支架联合空心螺钉克氏针内固定治疗经舟骨月骨周围脱位的效果. 社区医学杂志, 2018, 16(2): 31-32.
18. 张立国. 经舟骨月骨周围脱位治疗 11 例临床分析. 世界最新医学信息文摘, 2019, 19(44): 103-105.

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Clinical application of nitinol memory alloy two foot fixator combined with Kirschner wire in treatment of trans-scaphoid perilunate dislocation

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