采用来自桡骨远端的带血管蒂骨移植重建舟骨近端三分之一的骨不连骨折。
Reconstruction of scaphoid nonunion fractures of the proximal one third with a vascularized bone graft from the distal radius.
作者信息
Werdin Frank, Jaminet Patrick, Naegele Beate, Pfau Matthias, Schaller Hans-Eberhard
机构信息
Department for Hand, Plastic, Reconstructive Surgery, Burn Center, BG-Trauma Center, University of Tübingen, Tübingen, Germany.
出版信息
Eplasty. 2014 Jun 27;14:e24. eCollection 2014.
OBJECTIVE
The treatment of proximal located scaphoid nonunion is a well-known and common problem. For these patients, we used a vascular pedicled bone graft of the distal radius.
METHODS
In the last 7 years, 75 patients were treated with the vascular pedicled bone graft. Retrospectively, patients' data, healing rates, and factors influencing scaphoid healing were analyzed.
RESULTS
The overall healing rate in cases with proximal located nonunions (n = 54) was approximately 70%. Out of these 54 patients, 47 patients showed avascular proximal fragments. Multivariate analysis showed no significant impact for the factors age, smoking, duration of disease, or previous operation.
CONCLUSIONS
In our negative selected patient group, we were able to achieve good results with the usage of a pedicled vascularized bone graft of the distal radius. Our results indicate a favorable outcome for the use of a pedicled vascularized distal radius bone graft in both scaphoid nonunion fractures of the proximal third, with or without an avascular proximal pole.
目的
舟状骨近端骨不连的治疗是一个众所周知的常见问题。对于这些患者，我们采用了带血管蒂的桡骨远端骨移植术。
方法
在过去7年中，75例患者接受了带血管蒂骨移植治疗。回顾性分析患者数据、愈合率以及影响舟状骨愈合的因素。
结果
近端骨不连患者（n = 54）的总体愈合率约为70%。在这54例患者中，47例显示近端骨折块无血运。多因素分析显示年龄、吸烟、病程或既往手术等因素无显著影响。
结论
在我们经过筛选的阴性患者组中，使用带血管蒂的桡骨远端骨移植术取得了良好效果。我们的结果表明，带血管蒂的桡骨远端骨移植术对于近端三分之一舟状骨骨不连骨折，无论近端极有无血运，均有良好疗效。
Zotero 插件