采用2种方法经手掌入路向舟状骨中央置入螺钉的比较

"Purpose:
We studied 2 methods used for screw placement through a volar approach for fixation of scaphoid fractures.
Methods:
We performed measurements on 20 computed tomography scans of unfractured scaphoids. A central virtual guidewire was computed in 10 scaphoids with the wrist in neutral or in extension and ulnar deviation. Second, we compared the central guidewire and a guidewire representing a volar approach to the scaphoid avoiding the trapezium.
Results:
The central guidewire passed through the trapezium in all cases with the wrist either in neutral or in extension and ulnar deviation. There was a statistically significant difference only in the sagittal plane. When the central guidewire was compared with a guidewire placed through a standard volar approach, the latter was more eccentric in the distal and waist portions.
Conclusions:
We showed that central placement throughout the scaphoid with a standard volar approach is not feasible without partially resecting, manipulating, or drilling through the trapezium.
Clinical Relevance:
Our data suggest that a volar transtrapezial approach can be an alternative for optimum central placement in volar percutaneous fixation of scaphoid fractures."