Ye X, Feng J-T, Yin H-W, Qiu Y-Q, Shen Y-D, Xu W-D
Department of Hand Surgery, Huashan Hospital, Fudan University, No. 12, Middle Wulumuqi road, 200040 Shanghai, China.
Department of Hand and Upper Extremity Surgery, Jing'an District Centre Hospital, 259, Xikang road, Jing'an, 200040 Shanghai, China; Limb Function Reconstruction Center, Jing'an District Centre Hospital, 259, Xikang road, Jing'an, 200040 Shanghai, China.
Hand Surg Rehabil. 2020 May;39(3):207-213. doi: 10.1016/j.hansur.2020.01.005. Epub 2020 Feb 15.
Vascularized bone grafts have shown favorable outcomes in Kienböck's disease, preventing the progression of lunate collapse and avascular necrosis. Here we describe our experience using a 4+5 extensor compartmental artery (ECA) vascularized bone graft combined with K-wire fixation. Between September 2010 and June 2013, 9 patients with Lichtman stage II-IIIA disease underwent arthroscopy prior to 4+5 ECA graft placement combined with temporary fixation (scaphocapitate and triquetrum-capitate joints). The average follow-up was 69 months (range, 51-92 months). Changes in pain, range of motion, grip strength, and pinch strength were analyzed. All patients had satisfactory recovery, especially pain relief and grip strength improvement (both P<0.01). Furthermore, magnetic resonance imaging follow-up was critical for monitoring lunate revascularization, especially in the early postoperative period.
带血管蒂骨移植术在月骨无菌性坏死的治疗中已显示出良好的效果，可防止月骨塌陷和缺血性坏死的进展。在此，我们描述使用4 + 5伸肌间隔动脉（ECA）带血管蒂骨移植联合克氏针固定的经验。2010年9月至2013年6月期间，9例Lichtman II - IIIA期疾病患者在进行4 + 5 ECA移植联合临时固定（舟头关节和三角头关节）之前接受了关节镜检查。平均随访69个月（范围51 - 92个月）。分析了疼痛、活动范围、握力和捏力的变化。所有患者均获得满意恢复，尤其是疼痛缓解和握力改善（均P<0.01）。此外，磁共振成像随访对于监测月骨再血管化至关重要，尤其是在术后早期。
