Tsuyuguchi Y, Murase T, Hidaka N, Ohno H, Kawai H
Department of Orthopaedic Surgery, Osaka Rosai Hospital, Japan.
J Hand Surg Br. 1995 Apr;20(2):194-200. doi: 10.1016/s0266-7681(05)80049-x.
For appraisal of anterior wedge-shaped grafts for the humpback deformity of the scaphoid, a retrospective study of 27 cases with old scaphoid fractures or non-unions was carried out. 11 cases were treated with Herbert screw fixation and anterior wedge-shaped graft and the other cases with other methods. For the assessment of carpal alignment, radio-lunate and scapho-lunate angles were measured with peri-operative radiographs. For the clinical assessment, the scoring system of Cooney was applied. In 25 cases, primary bone union was obtained with one attempt and in two cases, with the second operation. Union was achieved in a mean of 3.4 months. The post-operative wrist score ranged from 65 to 100 with an average 81.2 points. There was a statistically significant relationship between the wrist score and the post-operative scapho-lunate angulation of the affected wrist. The humpback deformity of scaphoid non-union should be treated precisely with carpal realignment surgery or anterior wedge-shaped bone graft.
为评估用于舟状骨驼背畸形的前楔形植骨，我们对27例陈旧性舟状骨骨折或骨不连病例进行了回顾性研究。11例采用Herbert螺钉固定和前楔形植骨治疗，其他病例采用其他方法治疗。为评估腕关节对线情况，通过围手术期X线片测量桡月角和舟月角。临床评估采用Cooney评分系统。25例一次手术即实现一期骨愈合，2例经二次手术实现愈合。平均愈合时间为3.4个月。术后腕关节评分在65至100分之间，平均81.2分。患侧腕关节评分与术后舟月角成角之间存在统计学显著相关性。舟状骨骨不连的驼背畸形应通过腕关节复位手术或前楔形植骨进行精确治疗。
