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[舟状骨假关节及其手术治疗]

[Pseudarthroses of the scaphoid and its surgical treatment].

作者信息

Wozasek G E, Moser K D

出版信息

Zentralbl Chir. 1986;111(17):1039-47.

PMID:3538707
Abstract

Sclerotic bone ends and failure of union have quite often resulted from scaphoid fractures due to relatively insufficient blood supply to the proximal fragment. Clearly manifest scaphoid pseudarthrosis can be repaired only by surgery. Transplantation of cancellous or corticocancellous bone in combination with freshening of the sclerotic bone ends are priorities on which emphasis is laid in such surgical intervention. 38 patients with scaphoid pseudoarthrosis received surgical treatment in the casualty ward of Linz, between 1976 and 1982. The shortest follow-up interval for 30 patients was twelve months. 4 surgical methods were used, the technique of Streli in 16 cases, that of Matti-Russe in 9 instances, the Matti technique in 3 cases, and the Russe-II approach in 2 cases. Bony union was achieved in 90 per cent of the above patients. The technique of Streli was used in most cases for postoperative immobilisation, that is forearm cast for six weeks, which differed from other methods in which axilla to palm cast is applied up to twelve weeks. This paper has been prepared, with the view to describing results obtainable from various surgical approaches to scaphoid pseudoarthrosis.

摘要

由于近端骨折块血供相对不足,舟骨骨折常导致骨端硬化和骨不连。明显的舟骨假关节只能通过手术修复。松质骨或皮质松质骨移植联合硬化骨端清创是此类手术干预的重点。1976年至1982年间,38例舟骨假关节患者在林茨急诊病房接受了手术治疗。30例患者最短随访时间为12个月。采用了4种手术方法,其中16例采用斯特雷利技术,9例采用马蒂-鲁斯技术,3例采用马蒂技术,2例采用鲁斯-II入路。上述患者中90%实现了骨愈合。大多数病例术后采用斯特雷利技术固定,即前臂石膏固定6周,这与其他方法不同,其他方法采用腋窝至手掌石膏固定长达12周。本文旨在描述舟骨假关节各种手术入路可获得的结果。

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