青海地区采用桡动脉茎突返支带筋膜蒂桡骨茎突骨瓣移植治疗手舟骨骨折不愈合的临床应用  

The clinical application of styloid process bone flap with stylus recurrent branch of radial artery in the treatment of nonunion of scaphoid bone fracture in Qinghai province

作　　者：李洪飞 李二虎 曾学珠 汤波 杨国磊 Li Hongfei;Li Erhu;Zeng Xuezhu(Xining First People's Hospital,Xining Qinghai,810000,China)

机构地区：[1]青海省西宁市第一人民医院,青海西宁810000

出　　处：《生物骨科材料与临床研究》2018年第6期11-14,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨青海地区采用桡动脉茎突返支带筋膜蒂桡骨茎突骨瓣移植治疗手舟骨骨折不愈合的临床疗效。方法回顾性分析2015年3月至2017年5月本院采用桡动脉茎突返支带筋膜蒂桡骨茎突骨瓣移植治疗手舟骨骨折不愈合患者20例,并作为实验组,抽取2008年1月至2014年7月我院行取髂骨植骨克氏针内固定治疗手舟骨骨折不愈合有完整随访记录资料患者32例作为对照组;两组术后处理方式相同,随访半年后评估Cooney腕关节评分、ROM及骨折愈合情况。结果①Cooney评分:术后1周、3个月、6个月时实验组Cooney评分优于对照组(1周:t=-0.421,P=0.675; 3个月:t=2.978,P=0.040; 6个月:t=3.890, P=0.000);②ROM:术后两组腕关节ROM随愈合时间延长均逐步改善,对比有统计学意义(实验组:F=3.532, P=0.000;对照组:F=3.996,P=0.000),但组间对比无差异(术后3个月:t=0.236, P=0.814; 6个月:t=0.786, P=0.436);③骨折愈合:术后6个月时实验组骨折愈合优于对照组,对比有统计学意义(术后3个月:χ2=2.480,P=0.160; 6个月:χ2=3.900,P=0.040)。结论青海地区采用桡动脉茎突返支带筋膜蒂桡骨茎突。骨瓣移植治疗手舟骨骨折不愈合疗效确切,具有较高的临床应用价值。Objective To explore the clinical application of styloid process bone flap with stylus recurrent branch of radial artery in the treatment of nonunion of scaphoid bone fracture in Qinghai province.Methods To retrospectively collect20cases of non-union patients who were hospitalized in the first people's hospital of xining city from Mar2015to May2017as experimental group,extract from Jan2008to Jul2014in our hospital treated with iliac bone graft gram needle fixation for the hand of the scaphoid fracture nonunion with complete follow-up data recorded patients32cases as control group.Giving the same treatment,postoperative follow-up for half a year,evaluate Cooney wrist score,ROM,fracture healing,and statistical analysis.Results①Cooney score:postoperative1week,3months,6months,the experimental group Cooney score is better than that of control group(1week:t=-0.421,P=0.675;3months:t=2.978,P=0.040;6months:t=3.890,P=0.000);(2)ROM:There was no significant difference in ROM between the experimental group and the control group postoperative3months,6months(experiment group:F=3.532,P=0.000;control group:F=3.996,P=0.000),the two groups of ROM were gradually improved after operation,The comparison was statistically significant(3months:t=0.236,P=0.814;6months:t=0.786,P=0.436);③Fracture healing:the experimental fracture healing is better than that of control group after operation6months,compared with statistical significance(3months:χ^2=2.480,P=0.160;6months:χ^2=3.900,P=0.040).Conclusion It is of great clinical value to treat the fracture nonunion of scaphoid bone fracture by using the radial artery of the radial artery and the bone flap.

关 键 词：桡动脉茎突返支 骨移植 舟骨陈旧性骨折 高原地区 

分 类 号：R681.7[医药卫生—骨科学]