Comparative Outcome Analysis Effects Of Different Surgical Methods For Scaphoid Fracture

Objective:Evaluate the clinical effect of arthroscopic assisted reduction with percutaneous Herbert screw fixation and open reduction with Herbert screw internal fixation on the prognosis and functional recovery of scaphoid fracture.Methods:Retrospective analysis of patients admitted to our hospital from June 2015 to June 2016 who received arthroscopic assisted reduction with percutaneous Herbert screw fixation(22 cases in group A)and open reduction with Herbert screw internal fixation(28 cases in group B)for treatment of scaphoid fracture.At least one year of follow-up,The wrist joint function was evaluated by comparing the ulnar deviation,radial deviation,dorsiflexion,metacarpal flexion,disability of arm,shoulder and hand(DASH)questionnaire,wrist function Mayo score(including pain degree,function state,range of motion,grip strength)and Patient-Rated Wrist Evaluation(PRWE)score.Results:A total of 50 patients(22 patients in group A and 28 patients in group B)were included,and all patients had bone healing.At the last follow-up,the range of motion of wrist in group A was significantly higher than that in group B,and the difference between the two groups was statistically significant(P<0.05).The DASH scoring questionnaire showed that the mean score of self-evaluation in group A was 4.32±3.486,which was significantly lower than that in group B(8.51±4.594),and the difference was statistically significant(P < 0.05).The average Mayo wrist score in group A(94.09±9.466 points)was significantly higher than that in group B(80.00±10.364 points),The difference between the two groups was statistically significant(P < 0.05).The excellent and good rate of group A(86.36%)was greater than that of group B(60.71%),and the difference between the two groups was statistically significant(P < 0.05).Patient-Rated Wrist Evaluation PRWE self-score of group A(2.36±0.492 points)was lower than that of group B(3.68±0.116 points),and the difference between the two groups was statistically significant(P < 0.05).Conclusion:Arthroscopic assisted reduction and percutaneous fixation for the treatment of scaphoid fracture can better improve wrist function and has a significant effect.