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第四伸肌间隔动脉骨瓣在月骨无菌性坏死中的应用。

The use of fourth extensor compartment artery bone flap in Kienböck's disease.

作者信息

Aydemir Ahmet Nadir, Gönen Metin, Yorukoğlu Ali Çağdaş, Yücens Mehmet, Demirkan Ahmet Fahir

机构信息

Department of Orthopedics and Traumatology, Pamukkale University, Faculty of Medicine, 20070 Kınıklı, Denizli, Turkey.

出版信息

Eklem Hastalik Cerrahisi. 2019 Aug;30(2):124-9. doi: 10.5606/ehc.2019.62471.

Abstract

OBJECTIVES

This study aims to clinically evaluate the efficacy of pedicle bone flap treatment in stage II Kienböck's disease.

PATIENTS AND METHODS

This retrospective study included 10 patients (8 males, 2 females; mean age 33.3 years; range, 23 to 46 years) treated with pedicle bone flap between January 2012 and June 2016. In all patients, a fourth extensor compartment artery (ECA) pedicle bone flap from the dorsal surface of the radius was prepared and placed through a window opened on the lunate bone. Clinical results of the patients were evaluated according to the Mayo wrist score.

RESULTS

All patients could return to their daily activities after surgery. No superficial or deep infection developed requiring debridement or antibiotic use other than prophylaxis. None of the patients required reoperation due to complications or the progression of the disease. The mean Mayo wrist score was measured as 81 (good).

CONCLUSION

In this study, results of the fourth ECA pedicle bone flap application were found to be effective in the treatment of avascular necrosis of the lunate bone. Further comparative and long-term follow-up studies are required including large and homogeneous patient groups.

摘要

目的

本研究旨在临床评估带蒂骨瓣治疗Ⅱ期月骨无菌性坏死的疗效。

患者与方法

本回顾性研究纳入了2012年1月至2016年6月期间接受带蒂骨瓣治疗的10例患者(8例男性,2例女性;平均年龄33.3岁;范围23至46岁)。所有患者均制备了来自桡骨背侧的第四伸肌间隔动脉(ECA)带蒂骨瓣,并通过在月骨上开的窗口置入。根据Mayo腕关节评分评估患者的临床结果。

结果

所有患者术后均能恢复日常活动。除预防性使用抗生素外,未发生需要清创或使用抗生素的浅表或深部感染。没有患者因并发症或疾病进展而需要再次手术。平均Mayo腕关节评分为81分(良好)。

结论

在本研究中,发现应用第四ECA带蒂骨瓣治疗月骨缺血性坏死的效果良好。需要进一步开展包括大型同质患者群体的比较性和长期随访研究。

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