带蒂豌豆骨移位替代月骨治疗月骨缺血性坏死  

TreatmentofKienbock'sDiseasebyTransferofPedicledPisiformBoneforReplacementofLunate

作　　者：裴福兴[1] 杨志明[1] 黄富国[1] 张世琼 

机构地区：[1]华西医科大学第一附属医院骨科

出　　处：《中华骨科杂志》1996年第1期28-30,共3页Chinese Journal of Orthopaedics

摘　　要：作者从１９８６年３月～１９９３年６月采用带血管蒂豌豆骨移位替代月骨治疗月骨缺血性坏死１８例。术前按Ｌｉｃｈｔｍａｎ分期，Ⅱ期２例，Ⅲ期１６例。Ⅲ期１６例中有８例同时行腕骨间融合术。随访２５～５１个月，平均３年１个月。１７例腕痛缓解，腕关节活动和握力均有改善。Ｘ线片结果：带蒂豌豆骨植入位置正常。腕高比值、ＭｃＭｕｒｔｒｙ指数和桡舟角与术前比较没有显著差异。按周连圻介绍的标准进行评定：优１２例，良５例，可１例，优良率达９４％。我们认为带蒂豌豆骨移位替代月骨是治疗月骨缺血性坏死Ⅲ期的一种有效方法。FromMarch1986-June1993,18casesofKienbock'sdiseaseweretreatedbytransferofpedicledpisiformboneforreplacementoflunate.Amongthe18patients,11weremalesand7werefemales,andtheiragesaveraged29years.ThestageofpatientswereclassifiedaccordingtothemethodofLichtman.TwocaseswereinstageⅡ,16casesinstageⅢ.Amongthe16casesinstageⅢ,inter-carpalfusionwereperformedatthesametimein8cases.Alpatientswerefolowedupfor25～51monthswithanaverageof3yearsand1month.Completereliefofpainwasobtainedin17patients.Rangesofmotionofwristandgripstrengthwereimproved.X-rayfilmshowedthatthepositionofthepedicledpisiformbonewasinsite.Therewasnosignificantdiferenceincarpalheightratio、McMurray'sindexorradio-scaphoidanglebeforeandafteroperation.ThepatientswereevaluatedbyZhouLianqi'smethod:Twelvepatientswereexcelent,5patientsgoodand1patientfair.WeconsideredthatthetransferofpedicledpisiformboneinreplacementoflunatewasanefectivemethodforthetreatmentofKienbock'sdiseaseofstageⅢ.

关 键 词：带蒂豌豆骨 月骨缺血性坏死 骨移位 

分 类 号：R681.705[医药卫生—骨科学]