Ezquerra-Herrando L, Corella-Abenia E, Castillo-Palacios A, Blanco-Rubio N, Albareda-Albareda J
Acta Ortop Mex. 2012 Nov-Dec;26(6):354-7.
The controversy around the treatment of carpal scaphoid pseudoarthrosis has an important place in traumatology. The purpose of this paper is to compare bone healing after surgery for carpal scaphoid pseudarthrosis.
This is a retrospective study of the 50 cases of carpal scaphoid pseudarthrosis treated from 1992 to 2010. Data on sex, age, involved side, and smoking were collected. Pseudarthrosis was typified according to the Herbert and Fisher classification. We considered the surgical technique used, the time elapsed between the initial trauma and surgery, the presence or absence of healing, and the postoperative healing time and complications.
The sample included 49 males (98%) and one female (2%). According to Herbert and Fisher, 45 patients (90%) had D1 pseudarthrosis and 5 patients (10%) had D2 pseudarthrosis. Mean time between the fracture and surgery was 30 months (2-345). The surgical technique used was percutaneous without opening and curettage of the pseudarthrosis focus in 8 patients (16%), curettage and osteosynthesis screw in 7 patients (14%), and curettage, graft and internal fixation with Kirschner nails or screws in the remaining 34 patients (70%). Thirty-four patients (68%) achieved bone healing.
The delayed diagnosis and treatment of scaphoid pseudarthrosis is the most important prognostic factor affecting surgical success (p < 0.001).
腕舟状骨假关节治疗方面的争议在创伤学领域占据重要地位。本文旨在比较腕舟状骨假关节手术后的骨愈合情况。
这是一项对1992年至2010年期间治疗的50例腕舟状骨假关节病例的回顾性研究。收集了性别、年龄、患侧及吸烟情况等数据。根据赫伯特（Herbert）和费舍尔（Fisher）分类法对假关节进行分型。我们考虑了所采用的手术技术、初始创伤与手术之间的时间间隔、愈合情况、术后愈合时间及并发症。
样本包括49例男性（98%）和1例女性（2%）。根据赫伯特和费舍尔分类法，45例患者（90%）为D1型假关节，5例患者（10%）为D2型假关节。骨折与手术之间的平均时间为30个月（2 - 345个月）。所采用的手术技术为：8例患者（16%）采用经皮穿刺，不打开和刮除假关节病灶；7例患者（14%）采用刮除并使用接骨螺钉内固定；其余34例患者（70%）采用刮除、植骨并用克氏针或螺钉进行内固定。34例患者（68%）实现了骨愈合。
舟状骨假关节的延迟诊断和治疗是影响手术成功的最重要预后因素（p < 0.001）。
