Scaphoid Fracture with a Dorsally Dislocated Proximal Fragment as a Variant of Dorsal Perilunate Fracture-Dislocation

背側半月骨周圍骨折脫臼的變異型：舟狀骨骨折伴隨其近心端骨折碎片背側脫臼

林志(Chih Lin)

《北市醫學雜誌》 2卷2期 (2005/02) Pp. 213-219

https://doi.org/10.6200/TCMJ.2005.2.2.12

摘要

手腕關節的半月骨周圍骨折脫臼是非常的複雜，現在它們被視為是一種連續性的韌帶斷裂、骨摺或兩者伴隨的傷害。但是，分類卻很困難，一部份的理由是臨床上有很多微細變異的病例且文獻上時常有令人混淆和易起急執的命令，或許它的原因更爲複雜。所以，這個複雜的傷害到現在仍未完全的瞭解。更加來說，從來沒有一部個分類包含不伴隨有半月骨週圍脫臼惡舟狀骨骨摺。本篇文章描述一個更為混淆的病例，他有一個舟狀骨骨摺伴隨其近心聞風而動骨摺碎片背側脫臼和一個微細的背側頭狀骨骨軟骨骨摺，文獻花上尚未報告過。作者相信本病例代表一種背側半月骨周圍骨摺脫臼的變異且介於舟狀骨骨折和半月骨周圍骨摺脫臼之間的階段。它的受傷機轉和治療的方法將會予進一步的分析和討論。

關鍵字

舟狀骨骨折 ； 半月骨周圍脫臼 ； 半月骨周圍骨折脫臼 ； Herbert螺絲

並列摘要

Perilunate fracture-dislocations of the wrist are very complex. They are now generally described as a spectrum of injury leading to ligament disruption, fracture, or a combination of both. However, classification is difficult partly because of the many subtle variables encountered clinically and the often confusing and conflicting terminology used throughout the literature, but perhaps more. So, these complex injuries are not yet fully understood. Moreover, never has a classification included the scaphoid fractures that are not associated with perilunate dislocations. This paper will describe a more confusing case with a dorsally dislocated proximal fragment of the scaphoid fracture and a minor osteochondral fracture of the dorsal capitate head which has not been previously reported. The author believes this present case to be a variable of dorsal perilunate fracture-dislocations which represents an intermittent stage between the scaphoid fracture and perilunate dislocation stages of a spectral injured type of the wrist. The mechanism of injury and methods of treatment will be analyzed and discussed.

並列關鍵字

scaphoid fracture ； perilunate dislocation ； perilunate fracture-dislocation ； Herbert screw