Larson Annalise Noelle, Bishop Allen T, Shin Alexander Y
Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Tech Hand Up Extrem Surg. 2007 Dec;11(4):246-58. doi: 10.1097/bth.0b013e3180cab17c.
Treatment of scaphoid nonunions remains a challenging problem, especially in the setting of proximal pole avascular necrosis or humpback deformity. Conventional bone grafting techniques have demonstrated unpredictable results in the setting of collapse deformities, whereas pedicled dorsal distal radius vascularized bone grafts have recently been reported to have nearly a 50% failure rate when used in scaphoid nonunions with proximal pole nonunion. Free vascularized medial femoral condyle bone grafting is one option for the treatment of scaphoid nonunions with proximal pole avascular necrosis associated with a humpback deformity. The indications, contraindications, and technique of free vascularized medial femoral condyle bone grafting are presented for the treatment of scaphoid nonunions associated with proximal pole avascular necrosis and humpback deformities.
舟骨不愈合的治疗仍然是一个具有挑战性的问题，尤其是在近端骨块缺血性坏死或驼背畸形的情况下。传统的骨移植技术在塌陷畸形的情况下效果难以预测，而带蒂桡骨远端背侧血管化骨移植最近报道称，用于近端骨块不愈合的舟骨不愈合时，失败率接近50%。游离血管化股骨内侧髁骨移植是治疗伴有驼背畸形的近端骨块缺血性坏死的舟骨不愈合的一种选择。本文介绍了游离血管化股骨内侧髁骨移植治疗伴有近端骨块缺血性坏死和驼背畸形的舟骨不愈合的适应症、禁忌症及技术。
