桡骨远端骨瓣转移治疗晚期月骨无菌性坏死  

Outcomes of advanced Kienbock＇ s diseases treated by vascularized pedicled distal radius bone graft

作　　者：徐秀玥[1] 劳杰[1] 赵新[1] 顾玉东[1] 高凯鸣[1] 

机构地区：[1]复旦大学附属华山医院手外科,上海200040

出　　处：《中华手外科杂志》2008年第6期343-345,共3页Chinese Journal of Hand Surgery

摘　　要：目的报告以桡动脉腕背分支为蒂的桡骨远端骨瓣转移治疗晚期月骨无菌性坏死的手术方法及初步疗效。方法对2例晚期（Ⅳ期）月骨无菌性坏死患者，采用桡动脉腕背分支为蒂的桡骨远端骨瓣转移治疗。术后随访患者症状、腕关节活动度和腕关节影像学的改变，并用Krimmer评分表和DASH评分表进行功能评定。结果2例患者随访时间分别为3年和6个月，静息时疼痛均已消失，活动时疼痛程度减低。影像学表现：例1患者x线片月骨可见高密度坏死骨质已吸收，有新骨质形成；例2患者MRI显示坏死骨和腕骨塌陷无进一步进展。2例腕关节功能按Krimmer评分、DASH评分均较术前有明显的改善。结论桡动脉腕背分支为蒂的桡骨远端骨瓣转移术治疗晚期月骨无菌性坏死，初步疗效良好。Objective To investigate the outcomes of advanced Kienbock＇ s diseases treated by vascularized pedicled distal radius bone flap transfer. Method Two patients with advanced Kienbock＇ s diseases （type V） underwent distal radius bone flap transfer pedicled by dorsal branches of the radial artery. The observations included pain evaluation, radiography, function assessment of the wrist （ range of motion and Krimmer scale）, and quality of life （ DASH questionnaire）. Results Pain disappeared after surgery in both patients at rest, and reduced in intensity to a mild level during wrist motion. In one patient, X-ray showed the high density image of the lunate had disappered and new bone had formed. In the other patient, there was no aggravation in X-my or MRI. According to the assessment of hand function, the Krimmer score and DASH score were higher comparing with that assessed before the operation. Conclusion Distal radius bone flap transfer pedicled by dorsal branches of the radial artery is a feasible procedure to treat advanced Kienbock＇ s diseases, with favorable preliminary results.

关 键 词：月骨缺血性坏死 外科手术 骨瓣 

分 类 号：R686[医药卫生—骨科学]