Department of Surgery, Division of Plastic Surgery, University of Washington Medical Center, 325 9th Avenue, Seattle, WA 98013, USA.
Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, 4245 Roosevelt Way Northeast, Seattle, WA 98105, USA.
Hand Clin. 2024 Feb;40(1):105-116. doi: 10.1016/j.hcl.2023.08.001. Epub 2023 Sep 15.
Management of scaphoid nonunion remains challenging despite modern fixation techniques. Nonvascularized bone graft may be used to achieve union in waist and proximal pole fractures with good success rates. Technical aspects, such as adequate debridement and restoration of scaphoid length, and stable fixation are critical in achieving union and functional wrist usage. Rigid fixation can be achieved with compression screws, K-wires, and plate constructs. The surgeon has a choice of various bone graft options including corticocancellous, cancellous, and strut grafts to promote healing and correct the humpback deformity.
尽管采用了现代固定技术，舟状骨骨不连的治疗仍然具有挑战性。对于腰部和近极骨折，可采用非血管化骨移植来实现愈合，成功率较高。在实现愈合和功能性腕关节使用方面，技术方面（如充分清创和恢复舟骨长度以及稳定固定）非常关键。可以使用加压螺钉、K 线和钢板结构实现刚性固定。外科医生可以选择各种骨移植选项，包括皮质松质骨、松质骨和支柱移植，以促进愈合和纠正驼峰畸形。
