BACKGROUND:Scaphoid fractures are common wrist fractures.The percutaneous screw is used to treat scaphoid fractures.The closed reduction of the fracture site,the precise placement of the hollow compression screw in the scaphoid axis and the compression fixation of the fracture site can promote fracture healing and achieve the better function of the wrist. OBJECTIVE:To evaluate the efficacy of percutaneous hollow compression screw fixation of scaphoid fractures using a novel Kirschner wire guide. METHODS:Between January 2015 and December 2020,clinical data from 15 patients with scaphoid fractures selected at the Department of Hand Surgery,Third Hospital of Hebei Medical University were retrospectively analyzed.All patients underwent percutaneous hollow compression screw fixation by a novel Kirschner wire guide.Fracture healing time,operation time,number of intraoperative fluoroscopies,time to return to work and complications were collected.According to the modified Mayo wrist scoring system,the functional outcomes of wrists were assessed 12 months after surgery.Wrist flexion,extension,ulnar deviation,radial deviation and grip strength were measured. RESULTS AND CONCLUSION:All patients were followed up for 12 months.The compression screw was located in the axial position of the scaphoid by routine immediate postoperative radiographs.All scaphoid fractures united at an average of 10.0 weeks.The average operation time was 55.7 minutes.The number of intraoperative fluoroscopies was 10.9.The average time to return to work was 10.3 weeks.The results of wrist joint function were excellent in 9 cases,good in 5 cases,and average in 1 case,with an excellent and good rate of 93.3%.No significant differences in wrist flexion,extension,ulnar deviation,radial deviation and grip strength were found between the affected and healthy sides(P＞0.05).None of the patients had wound infection,malunion,screw displacement,or screw breakage.These findings indicate that the application of a novel guide can shorten the operation time,reduce the number of intraoperative fluoroscopies,improve the accuracy of screw insertion,and shorten the time to return to work.The function of the wrist was satisfactory after the operation.The novel Kirschner wire guide made percutaneous hollow compression screw fixation easier for scaphoid fractures.

This article highlighted the invaluable expertise of Academician TONG Xiaolin in managing severe cases of COVID-19， thereby providing ideas for the treatment of severe and critically ill patients with SARS-CoV-2 infection by integrating traditional Chinese and western medicine. It is believed that COVID-19 belongs to the “cold dampness epidemic” in traditional Chinese medicine， which is caused by pathogenic qi of cold and dampness. The course of the disease can be divided into four stages： constraint， block， collapse， and deficiency， and the severe cases are mainly in the block and collapse stages. The pathogenesis at the block stage is described as epidemic toxins blocking the lung， which should be treated by diffusing the lung and unblocking the bowels， resolving phlegm and unblocking collaterals. The primary formula used is Zilong Xuanbai Chengqi Decoction （子龙宣白承气汤） with modifications based on individual condition. The pathogenesis at the collapse stage is described as internal block and external collapse， which should be treated by restoring yang to save from collapse， boosting qi to relieve collapse， diffusing the lung and unblocking the bowels， resolving phlegm and unblocking collaterals， usually with the formula Poge Zilong Xuanbai Chengqi Decoction （破格子龙宣白承气汤） with modifications.