Zemirline A, Lebailly F, Taleb C, Naito K
Hand Center of Brittany, St Grégoire Private Hospital Center, 7, boulevard de la Boutière, 35760 Saint-Grégoire, France.
Clinique Saint Paul, 3, rue des Hibiscus, 97200 Fort-De-France, France.
Hand Surg Rehabil. 2019 Oct;38(5):280-285. doi: 10.1016/j.hansur.2019.07.007. Epub 2019 Aug 5.
For two decades, scaphoid nonunion has been treated arthroscopically. However, compressed cancellous bone graft does not have the same mechanical properties as corticocancellous bone graft for reducing the scaphoid humpback deformity and DISI tilt. Here, we describe an arthroscopic technique to treat Alnot stage IIB scaphoid nonunion. We treated a 27-year-old male patient for scaphoid waist nonunion with humpback deformity and DISI. A 8×8×10 mm cylindrical corticocancellous bone graft was harvested from the dorsal aspect of the radius using a single-use osteochondral autograft transfer system (OATS®, Arthrex Inc., Naples, USA). It was inserted in the nonunion site through an arthroscopic volar approach. Bone union was obtained at 3 months with lasting correction of the scaphoid humpback deformity and DISI. The functional result at 6 months was excellent. There were no complications. Scaphoid nonunion with humpback deformity and DISI may be treated arthroscopically with a corticocancellous bone graft.
二十年来，舟骨不愈合一直通过关节镜进行治疗。然而，在减少舟骨驼背畸形和DISI倾斜方面，压缩松质骨移植与皮质松质骨移植的力学性能不同。在此，我们描述一种治疗Alnot IIB期舟骨不愈合的关节镜技术。我们治疗了一名27岁男性患者，其舟骨腰部不愈合伴驼背畸形和DISI。使用一次性骨软骨自体移植转移系统（OATS®，美国那不勒斯的Arthrex公司）从桡骨背侧获取一块8×8×10毫米的圆柱形皮质松质骨移植块。通过关节镜掌侧入路将其插入不愈合部位。3个月时实现骨愈合，舟骨驼背畸形和DISI得到持久矫正。6个月时功能结果极佳。无并发症发生。伴有驼背畸形和DISI的舟骨不愈合可通过关节镜下皮质松质骨移植进行治疗。
