Ruch D S, Chang D S, Poehling G G
Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1070, USA.
Arthroscopy. 1998 Oct;14(7):747-52. doi: 10.1016/s0749-8063(98)70103-3.
The authors describe a technique of treating scaphoid nonunions with associated avascular necrosis consisting of arthroscopic resection of the distal pole of the scaphoid combined with radial styloidectomy. The results at 2-year follow-up showed all three patients to have complete relief of their mechanical pain and improvement in their range of motion as well as high satisfaction with the procedure. Modified Mayo Wrist Scores were a mean preoperatively of 60 and postoperatively of 88. Postoperative radiographs showed no increase in the scapholunate gap. However, the capitolunate angle increased from a mean of 3 degrees to 13 degrees . There was no progression of degenerative changes noted. The advantages of this technique include (1) minimal morbidity, (2) relief of mechanical pain, and (3) improved range of motion with no early degenerative changes. The rate and severity of degenerative change following this procedure remain unknown.
作者描述了一种治疗舟骨不愈合伴缺血性坏死的技术，该技术包括关节镜下切除舟骨远极并联合桡骨茎突切除术。2年随访结果显示，所有3例患者的机械性疼痛均完全缓解，活动范围改善，对该手术的满意度较高。改良梅奥腕关节评分术前平均为60分，术后为88分。术后X线片显示舟月间隙无增加。然而，头月角从平均3度增加到13度。未发现退变改变进展。该技术的优点包括：（1）发病率最低；（2）缓解机械性疼痛；（3）改善活动范围且无早期退变改变。该手术后退变改变的发生率和严重程度尚不清楚。
