Emory University School of Medicine, Atlanta , Georgia.
JBJS Rev. 2021 Apr 5;9(4):01874474-202104000-00001. doi: e19.00181.
»: Optimal management of nonunions of the proximal pole of the scaphoid is controversial and dependent on many patient and pathophysiologic considerations.
»: If the proximal pole subchondral bone support is sufficient, options include open reduction and internal fixation, either alone or in combination with autologous nonvascularized or vascularized bone graft.
»: If the proximal pole is not salvageable, replacement with osteochondral autografts or osteochondral flaps is the only option for reconstruction of the native anatomy.
»: 舟状骨近端骨不连的最佳处理方法存在争议,取决于许多患者和病理生理方面的考虑因素。
»: 如果近极骺下骨的支撑足够,可选择切开复位内固定,单独使用或与自体非血管化或血管化骨移植联合使用。
»: 如果近极无法挽救,使用自体骨软骨移植或骨软骨瓣移植是重建原生解剖结构的唯一选择。