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小儿舟状骨融合障碍手术治疗效果的临床与影像学评估

Clinical and Radiological Evaluation of Surgical Treatment Outcomes in Disturbances of Scaphoid Bone Fusion in a Pediatric Population.

作者信息

Koschel Piotr, Kaczmarek Leszek, Woźniak Jakub, Czarnecki Piotr, Romanowski Leszek

机构信息

Department and Clinic of Traumatology, Orthopedics, and Hand Surgery, Poznan University of Medical Sciences, 61-545 Poznań, Poland.

Lubuskie Centrum Ortopedii im. Dr. Lecha Wierusza w Świebodzinie, 66-200 Swiebodzin, Poland.

出版信息

J Clin Med. 2025 May 27;14(11):3758. doi: 10.3390/jcm14113758.

Abstract

This study aimed to investigate the results of surgical intervention in cases of scaphoid nonunion and delayed healing among individuals aged 18 or younger, focusing on both clinical and radiological aspects, as well as identifying possible factors that may impact the effectiveness or failure of the treatment. : A total of 20 boys with impaired scaphoid bone healing underwent surgical treatment, with the average duration between the suspected injury and the procedure being approximately 10.8 months. At the time of surgery, the patients had a mean age of 15 years, and the average follow-up period was 20 months. We assessed the type of surgery performed, along with range of motion and pain intensity, comparing preoperative findings with those recorded at the final evaluation. Based on lateral X-ray examination, CLA (capitolunate angle), SCA (scaphocapitate angle), and SLA (scapholunate angle) angles were measured before and after surgery and at the last follow-up. : The treatment results showed bone union in 18 out of 20 patients (90%), complete pain relief in 17 patients (85%), and a significant improvement in ROM. There was a statistically significant improvement in the SLA angle and an increase in wrist dorsal flexion. We also identified three factors that significantly influence better ROM after surgery, namely the values of the CLA and SLA angles, as well as the time from injury to surgery. : Our findings suggest that surgical intervention contributes to improved joint mobility, pain reduction, and restoration of anatomical alignment in the wrist. While we identified factors associated with more favorable functional results, we did not find any that were linked to a higher likelihood of treatment failure.

摘要

本研究旨在调查18岁及以下舟骨不愈合和延迟愈合患者的手术干预结果,重点关注临床和放射学方面,并确定可能影响治疗效果或失败的因素。共有20名舟骨愈合受损的男孩接受了手术治疗,从疑似受伤到手术的平均时间约为10.8个月。手术时,患者的平均年龄为15岁,平均随访期为20个月。我们评估了所进行的手术类型以及活动范围和疼痛强度,将术前结果与最终评估记录的结果进行比较。基于腕关节侧位X线检查,在手术前后及最后一次随访时测量头月角(CLA)、舟头角(SCA)和舟月角(SLA)。治疗结果显示,20例患者中有18例(90%)骨愈合,17例(85%)疼痛完全缓解,活动范围有显著改善。SLA角有统计学意义的改善,腕背伸增加。我们还确定了三个对术后更好的活动范围有显著影响的因素,即CLA和SLA角的值以及从受伤到手术的时间。我们的研究结果表明,手术干预有助于改善腕关节的活动度、减轻疼痛并恢复解剖对线。虽然我们确定了与更有利功能结果相关的因素,但未发现任何与治疗失败可能性增加相关的因素。

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