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" M / ?A !3 = QM@ 5 6 . @M H-0 QM =7 I. %
. [] =4
V
(;( ) . ! H ! aA# I. 23 R 571 (Fernands) ! );) = <- Z> < 7 ( 0F ,: 6) L ! 4 M ,: <- 3
. [] 9.(e
M ME ,: (Whipple –Herbert) 2
@ G =E <- M 3 ,M );
. ! 7 A /A -EP " M
28
. TI 6M 6 A E= ! @ . G ! =P O- "
=E
2
@ G3 = _ =E . (;;;) 3 5 . G 67 = # + ,A 64 . => Q4
. [] +3 A3 571 _ 75. : G ! ,: a
( ;;) ( ; ) .X " M 6 (Whipple-Herbert) 2
@ G =E )B
. [(]X M3 85 ,
I 3 . F% 0 Z>F hT
@M H-I ,@@A
29
(;B ) DE G M T3 G ! " ,: 5 ==4 @M ,=E W 5 )W
E 0
% -% 4 hT
R@A @M H-I . F%.D#L 3 4 = N
#
. [] F 0F ZF ?=A G 85 4
,MLEF
:M N
. . <
I . 9=/ O- " M =E )'
A -EP ?A (Yamamoto-Kawai) @ " M –a
.(;W) 5 I!F @5 " M@ 6 37
30
( ;W ) . TI 6M 6 A E= A4 @ . [] ! A _ ,:
: Q
&- = 2 M A
:
?A (Zaidemberg )3 A O0" Y!4 2 @ " M )b
. (;') 5 TI 6M =E 6 +3 O0" E= A4 @
31
( ;' ) #@ 0
3 A O0" &4 " M 6M@
: O @ ==A
_ ,:
: ! 7( T &@ -. = H
F 6 ) " M A
: 3
. [] ! A +3 A E= A4 @ ?A . : M = ( 4
/ O) 2 " M –c
. (;e;C) 3 5 TI 6M 6
,:
: M A Q- = =
G ! 5 " M A
. _ M 6
. [B] 9. (;)()= Z> < 7 Z4 ,: @ ,FA 5 2
F
32
(;C) ( ;e) E= A4 @ . 3 #@ 0
3 O0" &4 ( 4
/ O) 2 " M ) d
. TI 6M 6 +3 O
0"
& Y!4 -I -E> ?A) 3 #@ 0
5 O0" &4 T &@ 6 " M -E>
=>3 6M !
3A H-I 5 . (;;) 3 5 (O DE ! " 4 M ,:
:. _ &:
M A
: -E> M . [(] 5 / (Z> < 7 ) #E
(; ) ( ;) 33
5 I- ) ! " =
= . E> # 27 =
,:3 @M =E )e
.-L 4 = 2/ 4 27 =
<- . ( M Q=
-. Q
4 H
F 6 S A T FM A O
0" E= !3 A4 @ . TI 6M 6 ( B() 5 O Q# A
" ==A
: " 3#/ 3/ 0
: =34 R = 3#/ "/A a/
:
. 9=4 &/
!
.
M " 8
@ ! 5= 3# " A 6M@
)
Q@: 6 3 (;) M !3 FM A O! 9/
. (W)B) A /A @
:
.DE
= R5) 3 (;'); )M@ (B); ) M ( 4
/ ) 9 " 9M -E>
:
. (B) 5 3 #@ 0
3 O0" aM ( ! 5 /A R/
23 "/A 7 6 /3E ,
! 5 /A R/
7 " H-I A @
. 97. = : => 63 R= A =
. =34 <- =4 3#/ "/A R3X
:
. 9. (;)() = Z> < 7 4 !04 M ,:
:
( B ) ( B( ) 34
! S 23 =A f 5 0 /" RM H-0 =E - " @ )
: I
3=
G . =
F E> 5 =
F 3 R3M O- " M = Q3 )a
.Y= -
= 7F 3 =4 : 23 #A
. H-I M )b
.=
L Y = O-
M 71 3 @% = 5 3 #@ 0
- " -E. 0 <- )
. 3 3#/ ,0
5 O
: " #/
<
-05 .3 #@ 0
3 3#/ 7X ,A 4
/F " 5 MX7 /E <-
.O
: " #/3 71 3
6 @ ! " =
= E> ,FA 5 =
R@A @M H-0
. RM
: 9 3'<(
:#9 a
. 1 )
.# RM Q O Q# 3 )
:#9 b
.=
F = A4 5 )
.3#/ A ==A )
. O
: " #/ ?=A )
.,: 5 =E b. 4I )
Q#3 A N/ 6M Q 0r O0" &4 =3 A O0" &4 23 ZA QM7 )
. Neuroma # . O
. [] ( A E=) + R/
-
)
35
- Y&ِ\C\ UT+ُS -
36
: (Indroduction) A (Wrist) + 5 T ,- ( Scaphoid bone) ! " . [1](
Radius ) 3 #@ 0
= 7 + ,#% : !
. [2]
4% ( %()C) A ! " P
.Q =
H-I =# :.
"5A KL / = DE 5 E> DE 5 F
9 /G% O3 M :. H-I .TF = N/F =P Q I. . ,FA " 5 #@ & &> ?A ! " M
j4
j##E H-0
. [B] 9A 9G ME = ! " = Y!4 % T MAJ ?A ( Periosteal) " RA M
A G ! " . . 3#/
?=A : 2% 57F^ Y =
,- ! " % @ 2% @ 4 65=
(Nonunion )=
F = (Malunion )=
F Y (Delayedunion )=
F E> : ,MLE1
. _.. ( Secondry osteoarthritis) O
: " #/ ( Avascular necrosis )54 E
. [2]
83 @@A % = /" 23 :P -I
@M L 0 (
4!5 A) j== ` <- 5 Q3 =
F T 0
> ! " !
. 97. ! " =4 5 @M A4 KL #E KL
:P O3 M = + #/ 5 0 /" ,
M7 ?=A 2% &:=A = . =
F E> O=P
.= ! 4 % ?=A = /" 23 <
I ! &=4 5 A4 ,
@ == ! " KL RTM LE G
. [1]
=
F 5 0 Z> F ,FA
: ( Research importance) ‫أه ا‬
/ <
I !F ( A4 . "5A ) ! " KL 5 RM LE G
-I 2A ,!F 3 H-I A 23 0=@ = KL 5 RM # Z 3 hT
. = /" QM7 2% =P Q I. =A.
= 4
= 5L H-I =
R@A Q RM 75. ?A A
65= O- . = + 5 I /" ,
M7 0=
,A4> A4 KL RM #E -L 4 = 2/ 5 ! " 6 M RM ,/3E =
. A4 =4F @M 0I. 4 9 :> k4
37
27 =
! " KL 5 ,=E /3E A4 RM hT
= I. ,Y4 I hT
L1 =0 9VMLE 9 4% : @M ==A 4. <- 4 = 2/ 4
. [2
! " =
= E> ,FA KL 3 3
: (Reasearch purpose ) ‫هف ا‬
/3E A4 RM @ RM <- 3=
G ! " = #A !4 L1
.hT
75. R@A @M 2% #3 ! " KL 5
: ( Research materials) ‫ﻡدة ا‬
2/ 5 " = 4 - ! " 5 T = . E> 0= 97 (B;) = H-I ,3
. (;((C 6 2A ) ;((;) / LE -L 4 =
.4 5 DE A4 <
N ,4 ?L: 2% 27 @ )
. hT
=
F ?A =E :L: A4 RM @ , )
: (Research methods) ‫
ا ا‬
.O DA/ 7 #@ : RM )
.(3T 4/3E ) /3E ,7 5 +3 # : RM )
. ( Results & discussion) "#$‫& وا‬$‫ا‬
. A4 _ 9 0. = <- , M = ,FA 64 @ : , H-I ,
. + A = : . 3#/ " =
F : 38
: (Patients distribution according to surgical technique) 9 +# 5 '(
‫ﺕزع ا‬
A
23 4 5 3E [ A4 <
Y4% 9T ,
4 ?L: 2% :L: :F 27 )
: (Auto bony pin) - " @M 04 , 97 (;) :2 4 )
. ,FA 4% (%BC') 3 #@ 0
-E>
(Kirschner wires)
_ ,: M 04 , 27 (() 7 :
: 4 )
.,FA (%B;) . - /A " M 6
(Metal screw) [ = [ G ,: M 4 97. 27 (()7 :::4 . )
.,FA (%BB) . - /A " M 6
:<- () =4 ‫ ا" ق ا ا اث‬#$ %& '‫*زع ا‬+ #,- (١)‫اول ر‬
40'‫ﺝ‬6‫ت ا‬/01‫دا‬3
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4> 4'?3 @<+
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4‫ ﻡ@ﻥ‬4C $<0;*$
4> 4'?3 @<+
١٠
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4'?3 ‫ر‬0'D‫< ﻡ‬0;*$
4+‫ذا‬
١٢
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F,G‫ ا‬H- <
‫ت‬/01‫د ا‬3
%-*K'‫ ا‬LD7‫ا‬
: (Distribution of patients according to the complaint ) ‫"ی‬, ً .‫ﺕزع ا
(' ﺕ‬
: 23 27 0 64 S3 9 ,FA N! . = A ==A 6 . S 4 97 (;C) )
. + . = @M
5 Ef " KL R 5 4 27 (W) = ! " =4 9 @AF / 2% == a7 ( & 9=5 ) Y4 = 7F =A 8 )
.3 a Y4% Y
:. <- ( - E ?A) & = . =
. <- ( ; ) =4
39
M
9 27 N! ( ; ) =4
7F
KL R 5
= A ==A + + . = R
W
;C
,FA ==
B
;'
WW
%T (Distribution of injury according to the
radiologic seigns before surgery) :
‫
اﺡ‬5‫ ا‬6# 7."‫ت ا‬3., ً.‫ ﺕ‬01‫ﺕزع ا‬
: 23 9 A (B;) 5 6 .54 E
3 A# ,L 05 =4 A 0
M@5 ,
FA 6 5 (Proximal pole ) = QM@ 5)
. M@5 9 A ZE 5 (Waist )b! 5 )
. M@5 ,
FA : 5 (Distal pole)
#@ QM@ 5)
4 27 :L: ) : 3 ,! 3 ; :. 5= = ,FA 6 5
. ( _ 4 Ef : = G 4 : - "
" 4 27 ) : 3 ,! 3 ; . = = 9 A ZE
. ( _ 4 Ef : = G 4 : -
: 3 ,! 9 A ?L: 5 A 5 Q3# 97. = )
. - " @M ,4 ,
FA ZE
. _ @M ,4 ,
FA 6.
. = G M ,4 V 7. ,FA 6.
27 4 5 ,FA , 23 ! O
: " #/3 A# ,L ,- 9 A : <
I SE. A 3#/ 5 D@
A 3#/ kM Q3# ,FA 6. ) - " 4 -
kM Q3# 05 =A A) = G 4 - 27 4 5 ,FA 6. ( ,
L O=
40
5 M@5 : A ( ,L =4 = : A 3#/ 5 D@
O= =A A 3#/
.( ,L =4 O= SE. A 3#/ kM Q3# O= A )
_ 4 - 27 4
.A4 ,L3 9 ,FA N! (B) =4 ‫
ا ا‬, 30@‫ت ا‬0"@'O 0ً@,+ %& '‫*زع ا‬+ #,- (٣)‫اول ر‬
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‫*اف‬
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4‫ ﻡ@ﻥ‬4C $
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%٨٠
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%
٢٨،١
%
% -*K'‫ ا‬,D7‫ا‬
: (Distribution of injury according to the sex ) 8$5, ً .‫ ﺕ‬01‫ﺕزع ا‬
.?
% (e) 9- (;e) 0
97 (B;) 41 ,FA == +3
.?
1 #% 7. . A - #% ,X3 O.
:<- (W) =4 (9:
% %C' 9- %;') -I)
_7O 0ً@,+ %& '‫*زع ا‬+ #,- (٤)‫اول ر‬
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%& '‫دا‬3
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‫ذآ‬
‫ث‬0‫إﻥ‬
. (G)
0 ,#1 873 07 : - 0 0 M 2% <- =
41
: (Distribution of injury according to the work ) $9, ً .‫ ﺕ‬01‫ﺕزع ا‬
) = 04 O
= ,- 0 QA#. 97 : (=% ) = O
[ = O- 27 <
I 27 N! (') =4 a7 . ( j/E O
i = `) 9LM 27 (...T
# AL5 ( =E A4 <
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7c'‫@ ا‬,<
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4+‫ذا‬
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50<
0
%٠
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1
%٣،١
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E Q S= #1 H-I N "AL
-I . 9 (;) = 5 M +3
. (%BB) +3 ?A ! " 5=# = 5 23 ,- T/ I (;
. [6] 42
/ H-I 5 0 7 M
: <- =
.3 #@ 0
5 7
#X ?=A 0 <- (W) ,A ,#% =4 = "AL
Z #1 0 Q <- (
'( . ) =
,#% =4 = "AL
<-
. [7]
( " R Q) Y
=
#E (Colles fracture)
: (Distribution of injury according to the side) 95, ً .‫ ﺕ‬01‫ﺕزع ا‬
! 5 ,#1 == +3 . (%WW)
O. M@5 9 A (;C) 5 ! "
5 #1 ,
" 5 #1 5=# N/ . (C) =4 5 I %'e
M@5 ,FA (') .
T!/ =043 8 = #1 ?=A R: MF 23 ! . [8] M = I 9G
$0‫ﺹ‬6‫ ا‬c 0ً @,+ ‫ت‬/01‫*زع ا‬+ #,- (٧)‫اول ر‬
%-*K'‫ ا‬,D7‫ا‬
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٥
$0‫ﺹ‬6‫ا‬c‫ﺝ‬
%7'‫ا ا‬
‫ ى‬D‫ا ا‬
: (Company injuries with scaphoid fractures ) :#‫=< ا;ور‬.‫ذیت ا
ا?> ر ا‬A‫ا‬
. %B O. . SE. ,#^ = ,FA M@5 =A A ,@5
. (Radial process) O O1 Y2
#1 H-I ,
= 23 M@ I O O1 Y2
! " 7 g & Q <-
. [5]
O@ O0" M 6 ==
: (Time of surgery) :‫
اﺡ‬5‫ ا‬6B‫ اا‬C‫زﻡ‬
. ?=A _ 9 (#
0. .0.:L: ) A = 97 () 23 A4 E= )١
: 23 !
. - " M 04L 27 )
.
_ ,: 6 - /A " M M 04L 27 )
. = G ,: 6 - /A " M M 04L 27 )
43
. ?=A _ 9 (
.u #
0. ) A = 27 ()23 A4 E= );
: 23 !
. - " ! " =
F = A KL I=
27 :L: )
.
_ ,: 6 [ - [ /A [ " M ! " =
F = A KL I=
: 7 )
. = G ,: 6 [ - [ /A [ " [ M ! " =
F = A KL I=
27 :L: )
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: 23 !
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F = A KL I=
7 )
.
_ ,: 6 [ - [ /A [ " M ! " =
F = A KL I=
7 )
. = G ,: 6 [ - [ /A [ " M ! " =
F = A KL I=
=A 8 )
.(H= 5 6 A4 <
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‫ت‬/01‫د ا‬3
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@,; @$
#‫ و‬eP‫ وﻥ‬c‫أﺵ‬
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4‫ ﻡ@ﻥ‬4C ,$ ‫ه‬73 F,G‫ ا‬+ #-k‫ ا‬%& '‫د ا‬3
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44
: (Results)
&$‫ا‬
. A4 _ 9 2 0 = 9ALM# = 27 S= hT
= ,
: ( ) , 23 9= hT
H-I @ : (Clinical results )‫& ا
ی
ی‬$‫ ا‬-1ً
: (Pain ) <A‫ ا‬-a
4 - :F 27 4 (M@5 27 ) =
QG hT
3 = ,0". )
. (%BB) - " M
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?A . ( : #. : 7) =
@ O. Y4% 85 ?A =
F = Q /E . Eg 2
. E ?A &#T1 M7 !
. Ef A4 =
M 6 _ ,: M 4 - 27 4 (M@5 27 ) =
QG )
. (%e() /A "
O1 Y2
6M@ M7 = = . 0
: 2
?A . ( #. 27 . ) =
@ . Y41 -I = E ?A I=
O
. 57% A4 E= O. 75 - Eg :F =
9//E F
9 A 6 = G ,: M 4 - 27 4 (M@5 27 ) =
97. QG )
. (%C() /A " M
-. I=A. =
Q . = = . 0
: 2
?A . 4 Z/
27 :L: =
@ = QM@ #TF H=
M7 . G N!
= 2A O- ! G O 3#/ 7X
,- M : 8 =
Q . R Y41= = /" A ,
A E = ! "3
,- KL #E = -E = G N!
23 G. O- + : ! " 5 @
"
. T!/ KL 23 A = = A 8
=
F
9 A 9//E A 5 . + R:^ ,0
@
"
. c hT
?A ?L: RM @ () =4 45
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‫‪٧‬‬
‫‪١‬‬
‫‪٢‬‬
‫‪-‬‬
‫‪١‬‬
‫‪١‬‬
‫‪١‬‬
‫ ‪?L: RM T Q
c hT
@ ( ) MME‬‬
‫ی أ‪%‬‬
‫أ ‪%‬‬
‫أ ی‪%‬‬
‫
ﻥ ﺱ آ
ر‬
‫ا'‪ Q"X‬ا‪0,‬ﻥ‪ 4‬ر)‪(١‬‬
‫‪ -b‬ﺱ‪ .‬ﺡ
آ ا
ﺱ‪: ( Range of wrist movement ) F‬‬
‫ ‪. + A @ 5 H
= O- # - =F 03 3#A hT
8‬‬
‫ = ‪: I + ,A . =4
O"
@ 5‬‬
‫‪46‬‬
. (Q@) O=
! A
4= W( (=)O A
4= ;( A M 4= ( O0" M 4= C( )
. (@ RM1 6 3 0/" @ M 4= B( A M ,4=( 2 9/" = KA . + A ==A # (() =4 + A ==A # (() =4
A
F ==A =@
A
F ==A =@
M ==A =@
M ==A =@
+ A O=
!
O
A
O0"
4= ' .
,4= ( .
,4= ;' .
4= ;( .
=4
4= B( )'
,4= ( :.
4=e();'
4= B();(
@
4= B( :.
A . A =4F
4= e( :.
4= B( :.
T
9=4 ==A
M ,4 4 27 =
=4 + A =4 A hT
3 = ,0". = A 8
=
9 T A ?A . : 7 =
9 #
,
. (%BB) - " = O4. O- T!/ KL ,
A ?A . ( ! "3 = QM@ , H=
?=A O- &/
8I )
. Ef A4 E= O. 85 O- Eg =
9 @ + A ,
. ! "3 = QM@ #T
" M 6 _ ,: ,4 4 27 =
9 =4 + A ,
9##E) T + A ,
5 . 27 . =
a# A ==A =4 A 5 . (%e() /A
:F =
9 @ + A ,
. (O1 Y2
6M = ,
A ?A 0
: =
(O A
1
. (Ef A4 E= O. 75 -3) Eg
" M 6 = G ,: ,4 4 27 =
=4 A =4 )
. Eg :L: 27 =
9 #
+ A ,
. (%C() /A
5
A ?=A S=. & Q H=
= QM@ #T ?A ) 0
: =
V T + A ,
5
5 @
" ,- M Q O4. O- X R:1 Q +A Eg =@5 + A . T!/ KL3 N7E = + A 4 A = Eg 8 =
9 @ A ,
. (+
.?L: RM3 + A hT
() =4 47
t; ‫ ;@ آ ا‬n #‫ " ق ا ا اث ﻡ‬0$ 4‫ ا@ج ا ا‬p‫ﺉ‬0G‫ ﻥ‬#$ ‫رﻥ‬0H‫ ﻡ‬#,- ( ١١)‫اول ر‬
K;
١
٢
٢
*,H‫ﻡ‬
١
٢
١
‫ﺝة‬
١٠
٦
٧
‫ ا ا‬H- <
4+‫ا‬k‫ ا‬4'?@‫ر ا‬0'D'‫ا‬
7‫ آ ﺵ‬:;
4‫ ﻡ@ﻥ‬4C $
. ?L: RM T Q
+ A hT
@ (;) MME %‫ة‬
%#$%
%#&‫ﺱ‬
‫ر‬
!
‫ﺱ آ‬
‫
ﻥ‬
( ٢)‫ ر‬4‫ﻥ‬0,‫ ا‬Q"X'‫ا‬
:Grasp Force ‫ة ا‬# )c
: ,4= ?L: 2% , ?A 3 = 6 0
@ , 8 =
= @ = ,
. (/7 @ =4 ) M ,4 4 27 =
@5 =3 =4 =4 A hT
3 = ,0">5 )
Q I=A. =
/7 = ,
5 : Eg 7 =
= ,M7 . (%BB) - " . Eg 8 =
9 @ = ,
.9@AF 0 A 2% S=. &#T O- = QM@ ,
48
(%e() /A " M 6
_ ,: ,4 4 27 =
9 =4 = ,
<- )
= /" ,
A ?A) 0
: =
/7 = ,
5 :@ 27 =
9 M7 = ,
A 5 .
. Eg :F =
9 @ = ,
. ( O O1 Y2
6M = I=
= G ,: ,4 4 27 =
#r @5 =3 =4 =4 97. = )
. (%C() /A " M 6
E
?=A Q 8 =
/7 = ,
5 : @ :L: 27 =
9 M7 = ,
8 =
9 /7 = ,
. 0 A -I &#T ?A ! "3 = QM@ 5 54
8 . . X R:1 Y4% = 9 @ a# ,
A : + 5 @
" ,- ?=A Q Eg
- (?L: ,4 ) 27 64 = . T!/ KL 23 L
9 3 ,
A = 9 @ = ,
5 E
. <- (;) =4 . ?=A 0
0
0 ! 9 =4 I=
= /" ,
‫> ا‬u‫ و‬n #‫ " ق ا ا اﺙ ﻡ‬0$ 4‫ ا@ج ا ا‬p‫ﺉ‬0G‫ ﻥ‬#$ ‫رﻥ‬0H‫ ﻡ‬#,- (١٢ ) ‫اول ر‬
>@&
١
٢
٢
‫> ا‬u‫و‬
*,H‫ﻡ‬
١
٢
١
‫ ا ا‬H- <
‫ﺝة‬
١٠
٦
٧
4+‫ا‬k‫ ا‬4'?@‫ر ا‬0'D'‫ا‬
7‫ آ ﺵ‬:;
4‫ ﻡ@ﻥ‬4C $
?L: RM3 T Q
= /" hT
@ (B) MME %‫ ة‬#'‫و‬
%#$% #'‫و‬
%#&‫ ﺱ‬#'‫و‬
‫ر‬
‫ﺱ آ‬
‫
ﻥ‬
(٣)‫ ر‬4‫ﻥ‬0,‫ ا‬Q"X'‫ا‬
49
: (Radiologic results) 7."‫& ا‬$‫ ا‬-2ً
_ 9 0. =) +3 /3E ,7 = 27 64 4 # = ,0"B
: hT
( A4
. (%BB) - " M ,4 4 27 =
" =
,L )
. : 7 =
" =
= " M 6
_ ,: ,4 4 27 =
L
9 9" F
9 =
= ,0". )
. 27 . =
" =
= . (%e() /A
. I=A. =
=
F = F
9 P AM F Q _3 N!
M 6 = G ,: ,4 4 27 =
" =
F ?=A <- )
. Eg :L: =
" =
= . (%C() /A "
. I=A. =
=
F = F
9 P + 5 @
" ,- M . ?L: A4 RM hT
@ ( B) =4 30@‫ ا‬p‫ﺉ‬0G7‫ ا‬n #‫ " ق ا ا اث ﻡ‬0$ 4‫ ا@ج ا ا‬p‫ﺉ‬0G‫ ﻥ‬#$ ‫رﻥ‬0H‫ ﻡ‬#,- (١٣)‫اول ر‬
‫ل‬0‫ﻥﻡ‬/‫م ا‬3
‫ﻡ‬0‫ ا‬4'?@‫ل ا‬0‫ﻥﻡ‬/‫ت ا‬0‫ﻡ‬3
‫ ا ا‬H- <
٢
٤
٣
١٠
٦
٧
4+‫ا‬k‫ ا‬4'?@‫ر ا‬0'D'‫ا‬
7‫ آ ﺵ‬:;
4‫ ﻡ@ﻥ‬4C $
٩
٢٣
4O‫ت ا‬/01‫دا‬3
50
.?L: A4 RM3 T Q
hT
@ (W) MME %‫اﻥل )م‬
‫م اﻥل‬
)‫ر ذا‬
‫ﺱ آ‬
‫
ﻥ‬
(٤)‫ ر‬4‫ﻥ‬0,‫ ا‬Q"X'‫ا‬
: (Descussion of results) &$‫" ا‬#$‫ﻡ‬
SE + " 6 & M L ! "3 @= A =F A4 4 =0
@M ,:3 A4 RM ?L: = =@5 <- 23 Yq . 0 = /" 23 "/A D3E
:04T
9A7 R/ = .- /
g =# 5 23 hT
75. R@A
=
= E> 4 5 ( _ . = G Y ) ,: @M 6 =EF G 23 )
. ( = G3 %C( d _ %e() :. k4
R@A 0
^5 ! " =
F R@A 23 0= ?A - " @M R/ Z@ 64 ,0". @" =1 571 ,FA ( %BB ) 5 ! "3 M = "
.
A4 = = : #/ hT
(W) =4 51
(W) =4
hT
hT
=
=
" =
= A4 @M
+ A /7
@
=4
T
@
=4
==
/E
=4F
;
(
(
(
(
4+‫ا‬k‫ ا‬4'?@‫ر ا‬0'D'‫ا‬
W
e
;
;
e
;
;
e
;
;
e
7‫ آ ﺵ‬:;
B
C
;
C
;
C
;
C
4‫ ﻡ@ﻥ‬4C $
;B
'
W
;B
'
W
;B
'
W
;B
3 ==
,FA (%BB) 5 /" A
5 4% h
T
23 #A = 0" -I
. - " @M =
:Relation
between Union and Osteoarthritis
&!4 &0 <$
27 4 5 ,FA , 23 ! O
: " #/3 A# ,L ,- 9 A : <
I SE. A 3#/ 5 D@
A 3#/ kM Q3# ,FA 6. ) - " 4 -
kM Q3# 05 =A A) = G 4 - 27 4 5 ,FA 6. ( ,
L O=
5 M@5 : A ( ,L =4 = : A 3#/ 5 D@
O= =A A 3#/
.( ,L =4 O= SE. A 3#/ kM Q3# O= A )
_ 4 - 27 4
) T= &3A -% O
: " #/3 ,L 64 QG 64 2% " =
F 3 O=P
. 9=@ : SE A 5 HM >M ( M@5 3#/ kM Q3# 3A
-I .(%'B) A4 + 5 " #/3 ,L 0= ,
97 (;) =
=
F ?=A
.[9] A4 + 5 : " #/ =4 " =
F Q
3 52
(') =4 &
-I
(') =4
t; ‫ ا‬4U 4'?3 ‫ل‬0PU
‫ ا ا‬H- <
‫@ ا ا‬$
‫
ا ا‬,
١
٦
٢
٢
٢
٤
4'?@‫ر ا‬0'D'‫ا‬
4+‫ا‬k‫ا‬
7‫ آ ﺵ‬:;
4‫ ﻡ@ﻥ‬4C $
٥
١٢
4O‫ت ا‬/01‫دا‬3
: (Relation between Union and time of surgery ) ‫
اﺡ‬5‫ ا‬C‫ ;ﻡ‬:=.‫ﻥﻡل ا‬L‫ ا‬#M7
. ?L: RM 5 " =
F 05 ?=A (B;) #. 9 A (;B) . = =
A4 E= . #
0. .d 0. :L: = 05 A4 E= = A (B) 0
,
6 ,FA M@5 ,FA ?L: ,3=
= .97. ,3=
SE. ,
FA 6 23 . #
0.
. = 03 E= . =
F hT
6 A4 E= ! 9 ,FA N! ( e) =4 a7
. =
F hT
6 A4 E= ! 9 ‫ت‬/01‫*زع ا‬+ #,- (١٦)‫اول ر‬
7; @$
‫أوأآ‬
c‫@أﺵ‬,; @$
#‫ وأ
ﻡ‬eP‫وﻥ‬
7;
٥
٢
٤٠
٨
٥
٦٢،٥
‫@ ﺙﺙ‬$
#‫ وا
ﻡ‬c‫أﺵ‬
c‫@أﺵ‬,;
eP‫وﻥ‬
١٩
١٦
٨٤،٢
4‫
ا ا‬R‫ا‬G‫ ا‬#‫زﻡ‬
‫ت‬/01‫د ا‬3
O‫ﻡ‬7'‫ت ا‬/01‫د ا‬3
%‫ل‬0‫ﻥﻡ‬/‫ ا‬,D‫ﻥ‬
53
. [10]
=
F hT
d A4 E= ! @: L <
I . T#A1 = ,0".
hT
,
3 ! " =
= . E> ,FA 23 9 A4 E= ! 3 &
. ?A
#
0. = (%e;') d #
0. .d 0. :L: = (%W;) 75. =
F
.
= (%W() d . : (Relation between Union and position of fracture )
‫ ا‬N# :=.‫ﻥﻡل ا‬L‫ ا‬#M7
% (''') = QM@ 5 ME 6 ,
FA 6 #. M@5 ,
FA ZE 5 " =
F ?=A
% (CBB) b! 5 ME 6 A ZE #. M@5 A =A. 5 " =
F ?=A
. % (C') #@ QM@ 5 ME 6 ,
FA : #. M@5 ,
FA 6 5 " =
F ?=A
.<- (C) =4
D‫ ا‬QR S*'$ 4'?@‫ل ا‬0‫ﻥﻡ‬/‫ ا‬3 #,- (١٧)‫اول ر‬
4O‫ا@دا‬
٣٢
٢٣
4‫ﺹ‬0H‫ ا‬L"H‫ا‬
٨
٧
٨٧،٥
‫ زخ‬,‫ا‬
١٥
١١
٧٣،٣
4‫ ااﻥ‬L"H‫ا‬
٩
٥
٥٥،٥
D‫ ا‬S*‫ﻡ‬
‫
ا ا‬, ‫ت‬/01‫د ا‬3
O‫ﻡ‬7'‫ت ا‬/01‫دا‬3
%-*K'‫ ا‬,D7‫ا‬
. 6 5 =
L T Q
(') MME %‫ اﻥل‬#$‫ﻥ‬
%‫م اﻥل‬
‫ ااﻥ‬./%‫ا‬
‫
زخ‬$‫ا‬
2%‫ ا‬./%‫ا‬
(') MME
54
(%''') = QM@ H4 (%C') #@ QM@ 9 =
F 4= D
T#A1 = 0"
.(%CBB) b! 9
. ! " = 3 4= D
6 Q
-I
. = QM@ 5 9=4 9 T a# 2A b! H4 D
: . 9 =4 #@ QM@ ?A
= QM@ 5 Y =
F = / -I
. [1]
‫ ا‬OB 7 :=.‫ﻥﻡل ا‬L‫ ا‬#M7
Relation between Union and interspace of fracture
:
= 5 +3 /3E # 23 = 5 Z@ . A (;') 5 (3;) . ,
M@5 ,
FA ( C) 5 (3; ):. = 5 ,
= = 05 6 ,FA M@5 ,
FA ?L: 5 " =
F ?=A hT
= ,0".
. (3;) :
.SE ZE ,FA 9 A 5 =
F ?=A 8 = FM HA 9# ?=AF <- ! "3 @@A M 23 "/A Q4 &
. - =4 . " M 0
7F ?A . 5= 3# A
.T Q
6 @ ,FA N! () =4 D‫ ا‬QR 3 0,G$ 4'?@‫ل ا‬0‫ﻥﻡ‬/‫ ا‬3 #,- () =4
3=
,FA ==
. = =
3=
,FA ==
:. = =
05 4
3; 05 4
3;
. = =
:. = =
3; 3; A4 @M
B
- " '
;
_
e
;
= G
;(
;'
B
C
3 ,FA ==
%(
W;%
% =
F . [11] ME = = " =
F 9v 9
<
I . S
-I
. (%() =
F ,=! = 35 aA# Z (%W;)=
F ,3 = =! 35
55
: (Complication) ‫ ت‬MBL‫ا‬
H=
=E Ef 8
=
@
" ,- _ ,:3 H=
=E 8
=
i AM i A ]
?=A )
. 0!
M7 = . 9
= 9G ,:3
. 3 #@ 0
5 3#/ 7X3 &-. H! Q Ef 8
=
= G N!
M7 <- );
=A. =
A4 E= Y
:. O Q#3 A N/ 6M Q 0r O0" &4 23 ZA l )B
. - " I=
,: - 27
. ( = G
") : A 5 = QM@ 5 54 E
)W
@M : A - " @M =A A) ,FA ZE 5 " #5 )'
. ( _ @M 97. : A = G
. #/ ,MLEF () =4 () =4
41"D‫ن ا‬0G‫ﻥ‬/‫ا‬
_1‫ﺵ*اش ا‬
‫ت‬0<GR/‫ا‬
4‫ ااﻥ‬L"H‫'*ت ا‬+ 4H‫? وﻥ‬3 ‫ذات‬
4‫ور‬b‫@? ا‬O
H- <
‫ا ا‬
4D7+ ‫ل‬0PU
-‫ﺵ‬
Q;*G‫ﻡ‬
e>R
١
-
١
-
١
١
١
١
-
١
١
١
١
4'?3‫ر‬0'D‫ﻡ‬
7‫ آ ﺵ‬:;
4‫ ﻡ@ﻥ‬4C $
١
١
٢
١
١
٢
٢
4O‫ا@د ا‬
56
: (Conclusions) ‫ﺝت‬$‫ﺱ‬L‫ا‬
" 5 =
F = ?=A N/ . 2% = LE 03 3#A hT
3A : =
,:=A = !
. 9E> I=
A4 E= - 27 )
. T ?A ! " = ?3: 5 0= ME - 27 );
.3 (;) :. ME = 0= - 27 )B
. A4 + O
: #/3 A# ,L 0= - 27 )W
=
TF ?=A =! 2% " =
1 3 &3/ " M 0 @ 4 ?A 3 O=P )
A ME " 5 Q
@: Y4% . . DE - " I=
=E - 27
. " =
F = 0" N @M
5 =
. 9
4. 94 &
" =
F 3 5 3 = = @ G . _ I=
,: - 27 =
hT
23 3 ,MLEF:> 9A7 = = )
O
: " #/ 2A ( " 1 65 O- = =4 Q )
1 ,A =
7 + A ==A &
h
(3 #@ 0
5 3#/ aM3 &-. = ! Q ?=A O- )
.= ?A . " #/3 71 3 QA5 =
Q
R@A - " @F )
,A 4
/F " 7 MX7 /E 3#/ aM 9 3 #@ 0
H-I -E. O=P
4
/F " 7) MX7 N/ Q S-> = O- 3#/ 7X Y-G% A 3#/ 7X
03A 5 9##E 3#/ Z
,L 64 2A &5 Z
?=A 3@ ( 3#/ 7X ,A
. T=
.
" =
F 23 93 :P = O- ,: 5 = 7F 2% 571 )
.
_ ,: Y ) @M :. - " ,: @M S=4 R/ S
-I )
" 6 ,MLEF ?=A 3 ?A /" A A
5 ?A ( = G
. ?L: ,4 5 ,FA N
G 23 Em @M 5 0/ -
57
: (Comparing with another studies) ‫
ى‬BA‫ اراﺱت ا‬N‫ا>رﻥ ﻡ‬
. E. = 6 = @ (;) =4 (;) =4
(;(((C)
=
- " (;(()R=
(;((W)Sawazumi
=
b. 6 /A M
= 2 M
= @
b. 6 : M
= G
_
M 6
M 6
/A
/A
(
(
;
'(
W
,FA ==
;e
;e
;e
W'
-
e
e
e
'
B
?
1
;
;
;
;e
;;
@
%C(
%e(
%BB
%(
%(
=
F 34 5 I
) (Sawazumi) ?A 0 = 5 (%() =
F ,X3
. [7] : M = 2
q 9" 9M =E ?A (;((W #/ " A4 M
2/ ;((4 ) ( )= 0 ( R=) = 5 (%() =
F ,
. [5]
_ ,: 6 9/A 9" 9M =E ?A (R= 4 4 =
. ( %e(
_ ) %C( = G – %BB " ) = =
F Q
,
(;;) @ ?
1 #% 7. . (Sawazumi)= 5 ?
r - #% ,
. (;e) @ 7. E () R= = 5 ?
r - #% ,
. (;) @ 7. . = 5 ,X3
58
: (Advices) ‫ت‬0‫ا‬
.Q
, 5 4L = -E a ! " DA = -E% )
KA ,FA == D3@ 5 = aA# A 5 "5A KL RM N 23 => );
. A4 2%
R 7 ,:=A M Q
, 5 aA# QMF 7 =
== = A43 Y43 )B
. A4 hT
2% Y =
F
" 5 hT
75. R@A 23 =@ A43 23: @M I - " ,: @M E )W
. ! " =
= E> ,FA /3E
R/ V V 4% V 4T
R@A I Sawazumi 3 ,
@ = A4 04 > )'
. =0 RM 59
(References) N‫ا
اﺝ‬
1- CANALE.T.S ;DAUGHERTY.K ;JONES.L .Campbell,s OperativeOrthopaedics ,scaphoid
fracture.10th,Mosby,U.S.A,2003,3534-3606 .
،#- + @‫ﻡ‬0‫ ﺝ‬O‫ ﻡ‬. 4+‫ا‬k‫ ا‬4'?@‫ر ا‬0'D'‫< ا‬0;*$ 4‫ور‬b‫ل ا@? ا‬0‫م اﻥﻡ‬3‫ل و‬0‫ اﻥﻡ‬Rx+ 0@‫ ﻡ‬. '‫ أ‬،4‫ ﺝ*ﻥ‬-٢
.١٨ ،١٩٩٨، ٣‫ا@د‬،١٨O'‫ا‬
‫ اذ‬،#- + @‫ﻡ‬0‫ ﺝ‬،%‫و‬m‫@ ا‬,"‫ ا‬. 4‫ور‬b‫*ر ا@? ا‬D‫ آ‬،(‫*ع‬OR‫*ر و‬D‫ ا ا ا &)آ‬. #@‫ ﻡ‬،@; ‫ أ'؛‬،4‫ ﺝ*ﻥ‬-٣
.٢٣٥، ٢٠٠١،
٤- WATERS.P.M; STEWART.S.L . Avascular Necrosis of The Proximal Pole of The Scaphoid in
Adolenscents , The Journal of Bone & Joint Surgery.U.S.A,V84-A,N6,2002,1.
%>‫ ﻡ‬,G‫ ﻡ‬. 4,O1‫*ر أ' ا‬G‫ﺵ اف اآ‬z$(0c+0<GR‫ وا‬4‫ور‬b‫*ر ا@? ا‬D‫ آ‬$+ )‫*ان‬7@$ GD‫ﺝ‬0‫ ﻡ‬0;‫ر‬. R '1‫ ﻡ‬، -*@‫ ا‬-٥
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٦- SLADE III,.J; GEISSLER.W.B; GUTOW.A.P; MERRELL.G.A . Percutaneous Internal Fixation of
Selective Scaphoid Nonunions with an Arthoscopically Assisted Dorsal Approach,The The Journal of
Bone & Joint Surgery.UK,V86-A, Supplement4,2003,٣٢-44 .
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Metacarbal for Refrectory Nonunion of The Scaphoid ,The Journal of Bone & Joint Surger.,Japan,V86B,N5,2004,١٢-٢٢ .
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‫‪61‬‬
Analysis study of the results of surgical treatment in delayed union and nonunion
scaphoid fractures
Expirement of University Al-Assad Hospital betweenn ( 2002 -2007 )
* Dr Ahmad Jouni
** Dr Safwan Yousef
*** Dr Jihad Rahmoon
Abstract
The study included (32) patients between (2002-2007) who have come to Al-Assad University Hospital
with delayed union or nonunion scaphoid fractures.
The incidence rate in males was four times females rate (26 male, 6 females ) with mean age 28 years
old.
Results were studied after six months in 12 patients who were treated by fixing with auto bony pin
from the distal ends of radius, & 10 patients who were treated by fixing with Kirschner wires, & 10
patients who were treated by fixing with metal screw.
We followed up the patients for 12 months after surgery: - union happened in 10 patients in the first
group (83.3%) - union happened in ٦ patients in the second group (60%)- union happened in 7 patients
in the third group (70%).
The results of treatment by fixing with both Kirscshner wires and metal screw was bad ,but it was
good by fixing with auto bony pin in both union and function .
Keyword:
Delayed union , nonunion , pseudoarthrosis , auto bony pin .
* Professor , surgery department, faculty of medicine, Tichreen University, Lattakia, Syria .
** Associate professor, surgery department, faculty of medicine, Tichreen University, Lattakia, Syria .
*** Postgraduated student, surgery department, faculty of medicine, Tishreen University, Lattakia, Syria .
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