Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Hand Clin. 2024 Feb;40(1):117-127. doi: 10.1016/j.hcl.2023.08.004. Epub 2023 Sep 15.
If untreated, scaphoid nonunions may progress to scaphoid nonunion advanced collapse in a substantial portion of cases and may require salvage procedures. Multiple different techniques have been described to address scaphoid nonunion. Vascularized bone flaps (VBFs) are associated with faster time to union compared with nonvascularized grafts. Because these are local pedicled flaps, they do not require microsurgical anastomoses and should be within the armamentarium of all hand surgeons. Appropriately chosen local VBFs, can achieve union rates up to 90% to 100% in appropriately selected patients.
如果不进行治疗，舟状骨骨不连可能会在很大一部分病例中进展为舟状骨骨不连伴晚期塌陷，并可能需要进行挽救性手术。已经描述了多种不同的技术来解决舟状骨骨不连。与非血管化移植物相比，带血管骨瓣（VBF）与更快的愈合时间相关。由于这些是局部带蒂皮瓣，它们不需要显微外科吻合，并且应该是所有手部外科医生的必备工具。在适当选择的患者中，适当选择的局部 VBF 可以达到高达 90%至 100%的愈合率。
