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| Comparison of the effect of minimally invasive compression screw fixation through dorsal approach and volar approach in the treatment of scaphoid fractures |
| DONG Hong HE Yang ZHANG Pingfang ZHANG Hui WANG Jianmin ZHAO Yuzhou |
| The First Department of Orthopaedics, General Hospital of North China Petroleum Administration, Hebei Province, Renqiu 062552, China |
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Abstract Objective To investigate the clinical efficacy and safety of minimally invasive compression screw internal fixation through dorsal and volar approaches in the treatment of scaphoid fracture. Methods Eighty patients with scaphoid fracture admitted to the General Hospital of North China Petroleum Administration from January 2015 to August 2017 were randomly divided into dorsal approach group (n = 40) and volar approach group (n = 40). The dorsal approach group was treated with minimally invasive compression screw internal fixation through the dorsal approach, and the volar approach group was treated with minimally invasive compression screw internal fixation through the volar approach. The follow-up period was 1 year. The clinical efficacy of the two groups was evaluated and compared. The visual analogue scores (VAS) of the two groups before operation, 6 months after operation and 1 year after operation were compared. The intraoperative blood loss and fracture healing time were compared. The complications of the two groups during the follow-up period were recorded and compared. Results The excellent rate of clinical effect in volar approach group was significantly higher than that in dorsal approach group (P < 0.05). The VAS scores of the two groups at 6 months and 1 year after operation were significantly lower than those before operation, and the VAS scores of the volar approach group at 6 months and 1 year after operation were significantly lower than those of the dorsal approach group (P < 0.05). The bleeding volume and fracture healing time of volar approach group were significantly less than those of dorsal approach group (P < 0.05). The incidence of complications in volar approach group was significantly lower than that in dorsal approach group (P < 0.05). Conclusion Compared with the dorsal approach, the volar approach with minimally invasive compression screw internal fixation for carpal scaphoid fracture has more obvious clinical effect, which can shorten the healing time of fracture, reduce pain, and has better safety.
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