Tan Zhenwei, Xiang Zhou, Huang Fuguo, Yang Zhiming, Xiao Cong, Duan Xin
Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2018 Nov;97(48):e13229. doi: 10.1097/MD.0000000000013229.
No surgical procedure perfectly treats advanced Kienböck disease. Although vascularized os pisiform transferring (VOPT) is one of the main therapeutic approaches, reports on long-term follow-up and case series for this technique are scarce.We collected postoperative results in 11 patients with advanced Kienböck disease who underwent VOPT between 1986 and 2001 in our Hospital. Follow-up durations ranged from 15 to 26 years.At the last follow-up, excellent and good results were found in 81.8% according to the Modified Green and O'Brien score. Postoperative imaging revealed significantly reduced pisiform bone; carpal height ratio and Nattrass index were decreased, while the radioscaphoid angle was increscent, compared with preoperative and mid-term follow-up results.The favorable long-term results demonstrated that VOPT is a dependable and durable procedure for the treatment of advanced Kienböck disease, with pain relief and functional improvement despite some radiographic findings such as wrist osteoarthritis occurrence.
没有哪种手术方法能完美治疗晚期月骨无菌性坏死。尽管带血管蒂豌豆骨移植术（VOPT）是主要的治疗方法之一，但关于该技术的长期随访和病例系列报道却很少。我们收集了1986年至2001年期间在我院接受VOPT治疗的11例晚期月骨无菌性坏死患者的术后结果。随访时间为15至26年。在最后一次随访时，根据改良的格林和奥布赖恩评分，81.8%的患者结果为优或良。术后影像学显示豌豆骨明显缩小；与术前和中期随访结果相比，腕高比和纳特拉斯指数降低，而桡舟角增大。良好的长期结果表明，VOPT是治疗晚期月骨无菌性坏死的一种可靠且持久的方法，尽管出现了一些如腕关节骨关节炎等影像学表现，但仍能缓解疼痛并改善功能。
