Alnot J Y, Bleton R
Département de Chirurgie du Membre Supérieur-Urgences Mains, Hôpital Bichat, Paris.
Ann Chir Main Memb Super. 1992;11(4):269-75. doi: 10.1016/s0753-9053(05)80469-7.
Proximal row carpectomy has precise indications in cases of severe sequelae of scaphoid fractures. This procedure may be indicated either as first-line treatment in a case of advanced pseudarthrosis with osteoarthritis, particularly radio-scaphoid, or secondarily after scaphoid pseudarthrosis has been unsuccessfully treated by other methods. It is essential to make sure that the head of the capitatum and the radial surface of the lunate bone have a satisfactory appearance on plain X-rays, MRI and occasionally arthroscopy. The overall results of this operation which retains wrist movements and which also preserves a good grip strength are very encouraging, as demonstrated by the series of 48 cases of sequelae of scAphoid fractures treated by this technique.
舟骨近端切除术在舟骨骨折严重后遗症的病例中有确切的适应症。该手术既可以作为伴有骨关节炎（尤其是桡舟关节骨关节炎）的晚期假关节病例的一线治疗方法，也可以在其他方法治疗舟骨假关节失败后作为二线治疗方法。必须确保在普通X线片、磁共振成像（MRI）以及偶尔的关节镜检查中，头状骨头部和月骨的桡侧表面外观良好。该手术保留了腕关节活动且握力良好，其总体效果非常令人鼓舞，这在采用该技术治疗的48例舟骨骨折后遗症病例系列中得到了证实。
