The Volar Retrograde Applied Anatomy Of Wrist Scaphoid Fracture Screw Placement Technique And The Curative Effect Observation Of Early Postoperative Joint Taohongsiwu Decoction

Objective:1. Through autopsy study, comparing volar retrograde and anterograde screw placement technique of wrist scaphoid peripheral blood damage. To provide anatomical basis for the choice of the ways of clinical nailing.2. Place the volar retrograde screw technology applied in the clinical treatment of wrist scaphoid fracture and compared with volar anterograde screw placement technique, at the same time will be the nailing techniques with classic promoting blood circulation of TCM " Taohongsiwu decoction" joint application, and further discusses the clinical curative effect side with volar anterograde screw placement technique joint early postoperative Taohongsiwu decoction to treat wrist scaphoid fracture.Methods:1. The anatomic study:five fresh frozen corpse upper limb (a total of10), were randomly divided into control group (the volar anterograde screw placement technique), the experimental group (the volar retrograde screw placement technique), each group of five, were completed according to their surgical method to simulate the surgery, after vascular filling agent filled the local anatomy, to observe and compare the two groups of wrist scaphoid peripheral blood damage.2. Clinical application research:choose from March2012to August2013in this research,34patients with inclusion criteria and exclusion criteria. Successively, as specified in the hospital were randomly divided into control group (group A, n=13), the treatment group1(group B, n=11), the treatment group2(group C, n=10), A set of the volar anterograde screw placement technique, group B with volar retrograde screw placement technique, group C in group B on the basis of joint early postoperative Taohongsiwu decoction. The three groups of patients compare with preoperative and postoperative early clinical and radiological curative effect.Results:1. Through the anatomical study of five fresh frozen corpse upper limbs, the experimental group more than control group in the surgical clear vision, organizational structure to distinguish clearly, vascular leakage of filler rarely. The control group peripheral vascular were damaged more serious than experimental group accompanied by varying degrees of vascular leakage of filler.2. The three groups of patients compare with postoperative curative effect on fracture healing time, group C is the best, group B is in the next place, group C is worst, have significant statistical difference (P<0.05),4months after the Mayo wrist joint function score, group C is the best, group B is in the next place, group C is worst, have significant statistical difference (P<0.05). Operation time between groups had no significant statistical difference (P>0.05).Conclusion:1. The volar retrograde screw placement technique compared with the volar anterograde screw placement technique, the former has a smaller wrist scaphoid peripheral blood supply damage, can maximum limit protection wrist scaphoid blood supply.2. The volar retrograde wrist scaphoid fracture screw fixation is more advantageous than the anterograde fixed fracture healing and wrist joint function recovery;3. The wrist scaphoid fracture early postoperative oral Taohongsiwu decoction can promote the fracture healing, speed up the wrist joint function recovery.