Renner A, Egri L, Hardy G
Zentralinstitut für Traumatologie, Handund Mikrochirurgische Abteilung, Budapest.
Handchir Mikrochir Plast Chir. 1998 May;30(3):175-80.
There are various biomechanical procedures for the treatment of lunate necrosis in the literature, but only a few deal with the possible revascularisation of the bone. We used the second dorsal metacarpal vascular bundle implantation technique in different stages of Kienböck's disease. Since 1990, twelve patients were treated by this method. In stage I-II according to Lichtman, we implanted the vessels in the lunate after excochleation and cancellous bone grafting, in stage III we used a modified form of the Graner operation and revascularised the proximalised part of the capitate. In the first group, six patients, we observed significant improvement in five cases clinically, radiologically confirmed stagnation of the process in four cases. In the second group of six patients, the clinical symptoms improved in four cases, three patients had to change work and one patient developed a pseudarthrosis between the capitate and corticocancellous block, but the proximalised part of capitate survived in all cases. Vascular bundle implantation can be a helpful method in early stages of lunate necrosis, helping to slow or to stop the progression of the disease.
文献中有多种治疗月骨坏死的生物力学方法，但只有少数涉及骨的可能再血管化。我们在月骨无菌性坏死的不同阶段使用了第二掌背血管束植入技术。自1990年以来，12例患者接受了该方法治疗。根据Lichtman分期，在I-II期，我们在摘除月骨并进行松质骨移植后将血管植入月骨；在III期，我们采用了改良的Graner手术，对头状骨近端部分进行再血管化。在第一组6例患者中，5例临床症状显著改善，4例经放射学证实病变进展停滞。在第二组6例患者中，4例临床症状改善，3例患者不得不更换工作，1例患者头状骨与皮质松质骨块之间形成假关节，但所有病例头状骨近端部分均存活。血管束植入在月骨坏死早期可能是一种有用的方法，有助于减缓或阻止疾病进展。
