Schuind F, Moungondo F, El Kazzi W
Department of Orthopaedics and Traumatology, Erasme University Hospital, Université libre de Bruxelles, 808 route de Lennik, 1070, Brussels, Belgium.
Eur J Orthop Surg Traumatol. 2017 Jan;27(1):3-9. doi: 10.1007/s00590-016-1886-4. Epub 2016 Nov 28.
In this literature review, the authors analyse the prognostic factors in the curative treatment of scaphoid non-unions. The main negative prognostic factors are smoking, the time elapsed since the fracture, and avascular necrosis of the proximal fragment. If the latter is present, the revascularization by a pedicle or microsurgical bone autograft is probably the treatment of choice. In non-unions without evidence of osteonecrosis, vascularized bone grafts are probably not superior to conventional bone grafts, which can presently be performed under arthroscopic control, with minimal morbidity.
在这篇文献综述中，作者分析了舟骨不愈合根治性治疗中的预后因素。主要的负面预后因素包括吸烟、骨折后的时间推移以及近端骨块的缺血性坏死。如果存在后者，带蒂或显微外科自体骨移植进行血管重建可能是首选治疗方法。在没有骨坏死证据的不愈合病例中，带血管蒂骨移植可能并不优于传统骨移植，目前传统骨移植可在关节镜控制下进行，发病率极低。
