带蒂血管化骨移植治疗舟骨不愈合：临床结果、移植选择及适应证

Karaismailoglu Bedri, Fatih Guven Mehmet, Erenler Mert, Botanlioglu Huseyin

Ayancik State Hospital, Department of Orthopaedics and Traumatology, Sinop, Turkey.

Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Department of Orthopaedics and Traumatology, Istanbul, Turkey.

EFORT Open Rev. 2020 Jan 29;5(1):1-8. doi: 10.1302/2058-5241.5.190021. eCollection 2020 Jan.

Scaphoid nonunion is a challenging situation for orthopaedic surgeons. Nonunion rate is especially high in proximal pole fractures of the scaphoid due to tenuous retrograde blood supply.The use of pedicled vascularized bone grafts for the treatment of scaphoid nonunion provides both good clinical and radiological outcomes.The preserved vascularity of the graft leads to better bone remodelling, less osteopenia, faster incorporation and better maintenance of bone mass compared to the conventional non-vascularized grafting.Pedicled vascularized bone grafts also allow the correction of the carpal alignment and humpback deformity of the scaphoid.Clinical and radiological results have been satisfactory and promising, making us anticipate that the role of vascularized bone grafting for the treatment of carpal diseases will increase. Cite this article: 2020;5:1-8. DOI: 10.1302/2058-5241.5.190021.

舟骨不愈合对骨科医生来说是一个具有挑战性的情况。由于逆行血供薄弱，舟骨近端骨折的不愈合率尤其高。使用带蒂血管化骨移植治疗舟骨不愈合可带来良好的临床和影像学结果。与传统的非血管化移植相比，移植骨保留的血管可导致更好的骨重塑、更少的骨质减少、更快的骨融合以及更好地维持骨量。带蒂血管化骨移植还可纠正腕骨对线和舟骨驼背畸形。临床和影像学结果令人满意且前景乐观，这使我们预期血管化骨移植在腕部疾病治疗中的作用将会增加。引用本文：2020;5:1 - 8。DOI: 10.1302/2058 - 5241.5.190021。