UNASSIGNED: A 17-year-old autistic man presented with pilon-type bilateral fractures of the carpals after crashing his bicycle in a car with clenched fists around his bicycle handlebars. He had a displaced scaphoid, minimal displaced capitate and an undisplaced hamate fracture on the left side and an undisplaced scaphoid and displaced two-part capitate fracture on the right side. The fractures were reduced and stable fixation with screws performed. He was immobilized for 2 weeks and allowed early active motion. At 8 weeks the fractures had healed, and he obtained good function. At final follow-up after 6 months his nearest of kin reported excellent function, he had returned to his preinjury activity level. Range of motion and grip-strength was excellent and symmetrical. Radiographs and CT scans revealed healed fractures in anatomical position, no sign of ligament injuries, carpal instability or arthrosis.
UNASSIGNED: Multiple carpal fractures are not necessarily prone to reduced wrist function, pain and arthrosis, even in bilateral cases. If the ligaments are intact, stable fixation obtained and early mobilization obtained the fractures reduced and stable fixation obtained excellent hand and wrist function can be obtained.
■一名17岁的自闭症男子在自行车车把上握紧的拳头撞上一辆汽车后,出现了皮隆型的双侧腕骨骨折。他有一个移位的舟骨,左侧最小移位的头状骨和未移位的上肢骨折,右侧未移位的舟骨和移位的两部分头状骨骨折。骨折复位,螺钉固定稳定。他被固定了2周,并允许早期主动运动。8周时骨折愈合,他获得了良好的功能。在6个月后的最后一次随访中,他最近的亲属报告了良好的功能,他已经恢复到受伤前的活动水平。运动范围和握力是优秀的和对称的。X线照片和CT扫描显示骨折在解剖位置愈合,没有韧带受伤的迹象,腕关节不稳定或关节病。
■多发性腕骨骨折不一定容易降低腕关节功能,疼痛和关节病,即使在双边情况下。如果韧带完好无损,获得稳定的固定和早期动员,骨折减少,稳定的固定获得了出色的手和腕关节功能。