桡动脉茎突返支骨瓣移位治疗舟状骨不连  

Radial artery recurrent branch of styloid process bone flap transfer for treatment of scaphoid nonunion

作　　者：邢志利[1] 孙捷[1] 诸葛天瑜 谢玲丽[1] 吴维国[1] 罗靖致 

机构地区：[1]台州市博爱医院手足外科,浙江台州318050

出　　处：《中国骨伤》2010年第2期147-149,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨桡动脉茎突返支骨瓣移位治疗舟状骨不连的临床疗效。方法:2002年至2007年治疗舟状骨不连患者18例,男12例,女6例;年龄18～51岁,平均31.2岁。受伤至手术时间8～26个月,平均12.5个月。行桡动脉茎突返支为血供的桡骨瓣逆行移位嵌入舟状骨远近两端,交叉克氏针固定骨折及骨瓣,并切除桡骨茎突。术后石膏固定腕关节6～8周,去除石膏后行康复理疗和功能锻炼。X线示骨折愈合后拔除克氏针。结果:18例中15例获随访,时间8～25个月,平均13个月。15例骨折全部愈合。愈合时间8～12周。根据Anderson成人前臂骨折治疗效果评价分级:优14例,良1例。结论:桡动脉茎突返支骨瓣携带丰富血液循环,可使游离植骨爬行替代过程变为直接愈合过程。Objective：To investigate the clinical efficacy of radial artery recurrent branch of the styloid process bone flap transfer for treatment of scaphoid nonunion. Methods：From 2002 to 2007,18 patients with scaphoid nonunion included 12 males and 16 females with an average age of 31.2 years old ranging from18 to 51 years. Time from injury to operation was 8 to 26 months （averaged 12.5 months）. Radial bone flap blood supply by radial artery recurrent branch of styloid process was embedded in retrograde scaphoid shift distance at both ends,Kirschner wire fixed on the bone flap and bone fractures,and the radial styloid process was resected. Cast gypsum immobilization in a neutral place of wrist were performed for 6 to 8 weeks,the rehabilitation of physical therapy and functional exercise were performed after removal. Kirschner wire were removed after X ray showed fracture healing. Results：Among them,15 cases were followed up for from 8 to 25 months （means 13 months）. All fractures healed. The healing time was 8 to 12 weeks. According to adult forearm fracture evaluation of Anderson the results were excellent in 14 cases,good in 1. Conclusion：The radial artery recurrent branch of styloid process bone flap has a wealth of blood circulation,can make free grafting of the creeping substitution process directly into the healing process.

关 键 词：舟骨 骨折 不愈合 骨移植 

分 类 号：R683.41[医药卫生—骨科学]