桡动脉茎突返支骨瓣移植加桡骨茎突切除治疗腕舟骨骨不连  

Vascularized bone graft pedicled on the styloid recurrent branch of the radial artery combined with radial styloid excision for management of scaphoid nonunion

作　　者：颜屈伦 刘永光[1] 旷甫国 何勇[1] 徐頔[1] 张建[1] 叶西[1] 周盟森 

机构地区：[1]四川省第四人民医院骨科,成都610000 [2]邳州中铁二局二处医院手外科,江苏

出　　处：《中华手外科杂志》2014年第1期25-27,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨桡动脉茎突返支骨瓣移植加桡骨茎突切除治疗腕舟骨骨不连的手术疗效。方法采用腕舟骨切开复位，桡动脉茎突返支骨瓣移植加桡骨茎突切除，螺丝钉内固定治疗腕舟骨骨不连12例。结果术后10例获得随访，时间为3。30个月；2例失访。术后8．16周（平均11．8周）X线片显示骨折线均已消失，原坏死囊性变区域已有骨小梁通过。腕关节功能优良率达90％。结论桡动脉茎突返支骨瓣移植加桡骨茎突切除治疗腕舟骨骨不连是一种有效可靠的方法，促进骨不连愈合效果好，减少骨关节炎的发生。Objective To investigate the effect of vascularized bone graft pedicled on the styloid recurrent branch of the radial artery and excision of radial styloid for management of scaphoid nonunion. Methods Twelve cases of scaphoid nonunion were treated with open reduction and internal fixation of the scaphoid. At the same time the radial styloid was excised and a bone flap pedicled on the styloid recurrent branch of the radial artery was grafted. The range of foUow-up is from 3 to 30 months. Results Postoperatively 10 cases were follow-up for 3 to 30 months, while 2 cases were lost to follow-up. Radiographic evidence of fracture union was seen between 8 and 16 weeks postoperatively （mean, 11.8 weeks）. The necrotic and cystic areas were replaced by bone trabeculae. Good wrist function was achieved in 90% of the cases. Conclusion Vascularized bone graft pedieled on the styloid recurrent branch of the radial artery combined with radial styloid excision for the management of scaphoid nonunion is effective and reliable. It can cure the nonunion and reduce the occurrence of osteoarthritis.

关 键 词：舟骨 骨折 不愈合 骨折固定术 内 骨瓣 

分 类 号：R687.3[医药卫生—骨科学]