Clinical Center of Serbia, Orthopedic and Traumatology University Clinic, Belgrade, Serbia.
School of Medicine, University of Belgrade, Belgrade, Serbia.
Int Orthop. 2021 Apr;45(4):1017-1023. doi: 10.1007/s00264-020-04828-y. Epub 2020 Sep 30.
Fractures of the scaphoid account for 60-70% of all wrist bone fractures. The results of treatment in terms of bone healing vary depending on the type and location of the fracture, the time elapsed since the injury, the type of surgical treatment. Nonunion occurs in 5-15% of the cases on average. The purpose of this paper is to compare the surgical techniques and results of treating scaphoid nonunion (SNU) with osteoplastic xenografts of bovine origin or a vascularized autograft of the distal part of the dorsal radius.
We compare two groups of patients with symptomatic SNU, treated surgically with either a vascularized graft (n = 15) or a xenograft of bovine origin (n = 15). In the presurgical stage, the demographic characteristics of the patients, the time elapsed between injury and surgery, and classification of the injury (Schonberg, Herbert-Fisher, and Geissler-Slade) were recorded. One year following surgery, bone healing, total duration of the treatment, complications, the Mayo wrist score, and answers to the DASH questionnaire were analyzed.
No statistically significant differences between the two groups of patients were observed for bone healing (86.7% vs 80%) or functional results. A highly significant difference was observed with respect to duration of the surgical intervention in favor of xenografts.
The xenograft method is simple and relatively acceptable, providing good results in terms of healing and functionality.
舟状骨骨折占所有腕骨骨折的 60-70%。治疗结果（骨愈合）因骨折类型和位置、受伤时间、手术治疗类型而异。非愈合的平均发生率为 5-15%。本文旨在比较使用牛源性骨成形异种移植物或桡骨背侧远端带血管自体移植物治疗舟状骨骨不连（SNU）的手术技术和结果。
我们比较了两组有症状的 SNU 患者，分别接受带血管移植物（n=15）或牛源性异种移植物（n=15）手术治疗。在术前阶段，记录了患者的人口统计学特征、受伤与手术之间的时间间隔以及损伤分类（Schonberg、Herbert-Fisher 和 Geissler-Slade）。术后 1 年，分析了骨愈合、治疗总持续时间、并发症、Mayo 腕关节评分和 DASH 问卷的答案。
两组患者在骨愈合（86.7%对 80%）或功能结果方面无统计学显著差异。手术干预持续时间方面存在显著差异，异种移植物更具优势。
异种移植物方法简单且相对可接受，在愈合和功能方面提供了良好的结果。
