Nagura Nana, Naito Kiyohito, Sugiyama Yoichi, Obata Hiroyuki, Goto Kenji, Kaneko Ayaka, Tomita Yoshimasa, Iwase Yoshiyuki, Kaneko Kazuo, Ishijima Muneaki
Department of Orthopaedics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421 Tokyo, Japan.
Department of Orthopaedics, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421 Tokyo, Japan - Department of Orthopeadic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shisuna, Koto-ku, 136-0075 Tokyo, Japan.
SICOT J. 2021;7:13. doi: 10.1051/sicotj/2021011. Epub 2021 Mar 11.
Although vascularized bone grafting (VBG) using 1, 2 intercompartmental supraretinacular artery (1, 2 ICSRA) is effective for scaphoid nonunion, dorsal intercalated segment instability (DISI) deformity persists even after correction of humpback deformity (HD). The purpose of this retrospective study was to evaluate the correction of HD and DISI deformity after 1, 2 ICSRA VBG for scaphoid nonunion.
We treated 18 patients (mean age: 25.8, 16 males and 2 females) with scaphoid nonunion using a 1, 2-ICSRA VBG between January 2010 and December 2018. The average time from injury to surgery was 20.0 (3-120) months. The nonunions were located at the waist in all patients. The correction of HD and DISI deformity was investigated on the preoperative images and images at the last examination.
In all patients, the correction of HD was positively correlated with that of DISI deformity. Moreover, we focused on the time from injury to surgery and evaluated changes in HD and DISI deformity according to the time to surgery. As a result, changes in HD and DISI deformity were positively correlated in patients with a shorter time to surgery but were not correlated when the time to surgery exceeded 5 months.
These results suggest that DISI deformity can be corrected by correcting HD when the time from injury to surgery is short, but that correction is difficult if the time to surgery is prolonged.
尽管使用1、2间室上视网膜动脉（1、2 ICSRA）进行带血管蒂骨移植（VBG）治疗舟骨不愈合有效，但即使驼背畸形（HD）得到矫正，背侧插入节段不稳定（DISI）畸形仍会持续存在。本回顾性研究的目的是评估1、2 ICSRA VBG治疗舟骨不愈合后HD和DISI畸形的矫正情况。
2010年1月至2018年12月期间，我们使用1、2-ICSRA VBG治疗了18例舟骨不愈合患者（平均年龄：25.8岁，男16例，女2例）。受伤至手术的平均时间为20.0（3 - 120）个月。所有患者的不愈合均位于腰部。在术前影像和最后一次检查的影像上对HD和DISI畸形的矫正情况进行了研究。
在所有患者中，HD的矫正与DISI畸形的矫正呈正相关。此外，我们关注受伤至手术的时间，并根据手术时间评估HD和DISI畸形的变化。结果显示，手术时间较短的患者中，HD和DISI畸形的变化呈正相关，但手术时间超过5个月时则无相关性。
这些结果表明，受伤至手术时间较短时，通过矫正HD可矫正DISI畸形，但手术时间延长时矫正则困难。
