Kokmeyer Daniel, Merrell Gregory A, Kleinman William, Baltera Robert M
Indiana Hand to Shoulder Center, Indianapolis, IN.
Indiana Hand to Shoulder Center, Indianapolis, IN.
J Hand Surg Am. 2020 Feb;45(2):163.e1-163.e4. doi: 10.1016/j.jhsa.2019.10.013.
In patients with segmental nonunion of the distal radius, the distal ulna and distal radioulnar joint may not be salvageable. As an alternative to a vascularized free fibula, a pedicled distal ulna vascularized graft is a useful salvage technique. The procedure relies on the vascular bundle of the pronator quadratus and the dorsal oblique arterial anastomosis between the anterior and posterior interosseous arteries running along the interosseous membrane as the pedicle. We present 3 patients who received a distal ulna vascularized graft with concomitant wrist arthrodesis for distal radius segmental nonunion after complex distal radius fracture. This technique provides a local pedicled graft that may be a simpler, more reliable, and less technically demanding alternative.
在桡骨远端节段性骨不连患者中，尺骨远端及桡尺远侧关节可能无法挽救。作为带血管游离腓骨的替代方法，带蒂尺骨远端血管化移植是一种有用的挽救技术。该手术依赖于旋前方肌的血管束以及沿骨间膜走行的骨间前、后动脉之间的背侧斜行动脉吻合作为蒂。我们报告了3例因复杂桡骨远端骨折后桡骨远端节段性骨不连而接受尺骨远端血管化移植并同期进行腕关节融合术的患者。该技术提供了一种局部带蒂移植方法，可能是一种更简单、更可靠且技术要求较低的替代方法。
