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青少年舟骨不愈合的手术治疗:一种改良的带血管骨移植技术。

Surgical Treatment of Scaphoid Non-Union in Adolescents: A Modified Vascularized Bone Graft Technique.

作者信息

Bandinelli Diletta, Pagnotta Alessia, Piperno Alessandro, Marsiolo Martina, Aulisa Angelo Gabriele, Falciglia Francesco

机构信息

U.O.C. of Traumatology, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.

Hand and Microsurgery Unit, Jewish Hospital, 00148 Rome, Italy.

出版信息

Children (Basel). 2025 Aug 27;12(9):1135. doi: 10.3390/children12091135.

Abstract

: Although adolescents are at a lower risk of developing scaphoid non-union than adults, this complication is not uncommon in younger patients. The current gold standard for surgical treatment is non-vascularized bone grafting from the iliac crest or distal radius, and it is often considered the first-line option. However, non-union can persist in 10-20% of cases, and failure rates can reach up to 50% when the proximal pole is necrotic. : We evaluated a modified vascularized bone graft surgical technique in selected adolescent patients, with the goal of avoiding growth-related complications. Our experience is based on three cases of scaphoid non-union treated surgically between June 2019 and June 2022. : The modified surgical technique has shown promising results in the selected cases and carries no risk of donor site morbidity. It enables preservation of severely compromised scaphoid bones, prevents early-onset wrist osteoarthritis, and facilitates the return to sports activities for young patients.

摘要

虽然青少年发生舟骨不愈合的风险低于成年人,但这种并发症在年轻患者中并不罕见。目前手术治疗的金标准是取自髂嵴或桡骨远端的非带血管骨移植,它常被视为一线选择。然而,10% - 20%的病例中不愈合仍会持续存在,当近端骨坏死时失败率可达50%。我们评估了一种改良的带血管骨移植手术技术,用于特定的青少年患者,目的是避免与生长相关的并发症。我们的经验基于2019年6月至2022年6月期间手术治疗的3例舟骨不愈合病例。改良手术技术在所选病例中显示出了有前景的结果,且无供区发病风险。它能够保留严重受损的舟骨,预防早期腕关节骨关节炎,并有助于年轻患者恢复体育活动。

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