Steiger R, Sennwald G
Klinik für Orthopädische Chirurgie des Kantonsspitals St. Gallen.
Handchir Mikrochir Plast Chir. 1990 May;22(3):152-5.
Beyond elimination of pain, the objective of surgical treatment of scaphoid pseudarthrosis is the prevention of otherwise inevitable arthrosis of the wrist. In a follow-up of twenty-five patients over at least ten years post-operatively, the rate of union, but above all, the development of carpal instability and arthrosis was investigated. In the healed scaphoid, instability did not increase, although signs of arthrosis were found in almost all patients. As a rule, the degree of arthrosis was more pronounced in those cases with persisting subluxation of the lunate and DISI pattern of instability. Consequently, simultaneous correction of lunate subluxation via ligament reconstruction must be recommended when scaphoid pseudarthrosis is to be treated effectively. Late results of this modified procedure are not yet available though.
除了消除疼痛外,舟状骨假关节手术治疗的目的是预防腕关节不可避免的关节病。在对25例患者进行至少术后10年的随访中,研究了愈合率,尤其是腕关节不稳定和关节病的发展情况。在愈合的舟状骨中,虽然几乎所有患者都有骨关节炎的迹象,但不稳定情况并未增加。通常,在月骨持续半脱位和DISI不稳定模式的病例中,骨关节炎的程度更为明显。因此,当要有效治疗舟状骨假关节时,必须建议通过韧带重建同时纠正月骨半脱位。不过,这种改良手术的远期效果尚不可知。