Mathoulin Christophe L, Arianni Margareta
1 Institut de La Main, Clinique Bizet, Paris, France.
2 Ramsay Premier Bintaro Hospital, Tangerang, Indonesia.
J Hand Surg Eur Vol. 2018 Jan;43(1):13-23. doi: 10.1177/1753193417739526. Epub 2017 Nov 6.
Treatment of scaphoid fractures has been focused mainly on achieving union, with less attention to restoring normal scaphoid shape and orientation. Malalignment of one carpal bone will disrupt the kinetics of the entire wrist. The dorsal intercalated segment instability deformity associated with scaphoid waist nonunion is a nondissociative form of carpal instability. It has to be reduced in the treatment of scaphoid waist nonunions to avoid kinetic problems that will lead to arthritic changes. Computerized tomography scanning has become indispensable to visualize the humpback deformity clearly. Different techniques may be used to restore the normal anatomy of scaphoid, from non-vascularized graft to arthroscopic bone grafting, and also the option of vascularized bone grafting.
舟骨骨折的治疗主要集中在实现骨折愈合上，而对恢复舟骨的正常形态和方向关注较少。一块腕骨的排列不齐会扰乱整个腕关节的动力学。与舟骨腰部不愈合相关的背侧插入节段不稳定畸形是一种非分离性腕关节不稳定形式。在治疗舟骨腰部不愈合时必须对其进行复位，以避免导致关节炎改变的动力学问题。计算机断层扫描对于清晰显示驼背畸形已变得不可或缺。从非血管化植骨到关节镜下植骨，再到血管化骨移植，可采用不同技术来恢复舟骨的正常解剖结构。
