Ernst Stephen Michael Crowe, Green David P, Saucedo James M
Department of Orthopaedics, UT Health San Antonio, San Antonio, TX.
Hand Center of San Antonio, San Antonio, TX.
J Hand Surg Am. 2018 Sep;43(9):837-843. doi: 10.1016/j.jhsa.2018.03.048. Epub 2018 Jun 20.
Scaphoid fracture nonunion can often lead to pain, arthrosis, and disability. While typically the result of delayed diagnosis or inadequate treatment, it can sometimes occur even if the initial care was timely and appropriate. Whereas early recognition of acute fractures allows for nonoperative management, nonunions frequently require surgical treatment. Traditionally, this has involved open debridement and bone grafting. However, some publications suggest that certain stable nonunions may be amenable to percutaneous debridement and fixation without formal bone grafting. Although certain characteristics appear to be appropriate indications for such management, well-designed clinical studies are needed to better define them.
舟骨骨折不愈合常可导致疼痛、关节病和残疾。虽然通常是延迟诊断或治疗不当的结果，但有时即使初始治疗及时且恰当，也可能发生。早期识别急性骨折可进行非手术治疗，而骨折不愈合则常需手术治疗。传统上，这涉及开放性清创和植骨。然而，一些文献表明，某些稳定的骨折不愈合可能适合经皮清创和固定，而无需进行正规的植骨。尽管某些特征似乎是这种治疗的合适指征，但仍需要设计良好的临床研究来更好地界定它们。
