Jaminet P, Werdin F, Pfau M, Götz M, Manoli T, Rahmanian-Schwarz A, Schaller H E
Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, Berufsgenossenschaftliche Unfallklinik, Eberhard-Karl-Universität Tübingen, Schnarrenbergstraße 95, 72076, Tübingen, Deutschland.
Unfallchirurg. 2012 Nov;115(11):994-9. doi: 10.1007/s00113-011-1956-3.
We present a retrospective study on different treatment options for scaphoid nonunion. The results are compared to the literature and a treatment algorithm is proposed.
Based on a retrospective case-control study, 208 patients suffering from scaphoid nonunion were treated between 2000 and 2006. The patients were grouped depending on the localization of the nonunion: proximal (n=10), middle (n=105), or distal (n=93) third. In the presence of a small avascular proximal fragment, a vascularized bone graft from the distal radius was added (n=53). The determination of scaphoid healing was achieved by conventional radiographs or CT scans.
Overall scaphoid healing occurred in 89.9% (n=187). For small proximal scaphoid fragments (n=93), we could show healing rates up to 83% (n=77). Using a vascularized bone graft from the distal radius, scaphoid consolidation was achieved in 81% for avascular proximal fragments and recurrent scaphoid nonunion (n=53).
Using sophisticated treatment options, the prognosis of scaphoid nonunions is very good.
我们对舟骨不愈合的不同治疗方案进行了一项回顾性研究。将结果与文献进行比较，并提出了一种治疗算法。
基于一项回顾性病例对照研究，2000年至2006年间对208例舟骨不愈合患者进行了治疗。根据不愈合的部位对患者进行分组：近端（n = 10）、中部（n = 105）或远端（n = 93）三分之一。对于存在小的近端无血管碎片的情况，添加来自桡骨远端的带血管骨移植（n = 53）。通过传统X线片或CT扫描确定舟骨愈合情况。
总体舟骨愈合率为89.9%（n = 187）。对于小的近端舟骨碎片（n = 93），我们发现愈合率高达83%（n = 77）。使用来自桡骨远端的带血管骨移植，无血管近端碎片和复发性舟骨不愈合（n = 53）的舟骨愈合率为81%。
采用复杂的治疗方案，舟骨不愈合的预后非常好。
