Boretto Jorge G, Fernandez-Fernandez David, Gallucci Gerardo, De Carli Pablo
1 Hospital Italiano de Buenos Aires, Argentina.
2 Complejo Hospitalario de Cáceres, Extremadura, España.
Hand (N Y). 2017 Sep;12(5):NP88-NP91. doi: 10.1177/1558944716672203. Epub 2016 Sep 22.
Carpometacarpal joints can be affected by traumatic or degenerative pathology. Although different techniques have been described to treat these conditions, most authors agree that arthrodesis is an effective treatment modality. Vascularized bone grafts of the distal radius have been used to treat carpal conditions, such as scaphoid nonunion or Kiënbock disease, and they have been shown to have several advantages over nonvascularized bone grafts.
We report a case of a carpal boss in a female patient treated with an arthrodesis of the second and third carpometacarpal joints by using the fourth extensor compartment artery vascularized bone graft.
At 6 weeks postoperative bone union was achieved. At 2 years follow-up the patient was able to perform daily life activities without pain.
The fourth ECA VBG with reverse blood flow from the dorsal intercarpal arch allowed the graft to reach the CMC. A solid fusion was obtained at 6 weeks due to the biological advantage of the VBG.
腕掌关节可受创伤性或退行性病变影响。尽管已有不同技术用于治疗这些病症，但大多数作者认为关节融合术是一种有效的治疗方式。桡骨远端带血管蒂骨移植已用于治疗腕部疾病，如舟骨不愈合或月骨无菌性坏死，并且已证明其相对于非带血管蒂骨移植具有若干优势。
我们报告一例女性腕部腱鞘囊肿患者，采用第四伸肌支持带动脉带血管蒂骨移植对第二和第三腕掌关节进行关节融合术治疗。
术后6周实现骨愈合。随访2年时，患者能够无痛地进行日常生活活动。
来自腕背间弓的逆行血流的第四伸肌支持带动脉带血管蒂骨移植使移植骨能够到达腕掌关节。由于带血管蒂骨移植的生物学优势，在6周时获得了牢固的融合。
