中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2010年
11期
1025-1028
,共4页
舟骨%骨折固定术,内%外固定器%显微外科手术
舟骨%骨摺固定術,內%外固定器%顯微外科手術
주골%골절고정술,내%외고정기%현미외과수술
Scaphoid bones%Fracture fixation,internal%External fixator%Microsurgery
目的 评价桡骨远端背侧带血管蒂骨瓣转位联合腕关节外固定支架治疗陈旧性舟骨骨折的中远期疗效.方法 回顾性分析1995年2月至2006年11月行桡骨远端背侧带血管蒂骨瓣转位联合腕关节外固定支架治疗的13例陈旧性舟骨骨折患者,其中男12例,女1例;平均年龄为29.7岁(21～42岁);9例伴近侧极缺血坏死.受伤至手术时间平均为22.2个月(8～46个月).血管蒂为1,2区间间伸肌支持带上血管.固定方式包括螺钉或克氏针内固定及外固定支架固定.评价方式包括Mayo腕关节临床功能评分以及影像学评价.结果 13例患者术后获平均82.9个月(62～116个月)随访,骨折均获愈合,平均愈合时间为11.2周(8～15周).Mayo功能评价:优3例,良8例,可2例.末次随访时,舟骨角、舟月角、Mayo评分、关节活动度、握力均较术前有显著提高.结论 以1,2区间间伸肌支持带上血管为蒂的桡骨远端背侧骨瓣转位联合腕关节外固定支架治疗陈旧性舟骨骨折,手术过程相对简单,疗效满意.使用外固定支架是能够早期进行功能锻炼进而改善腕关节功能的重要因素.
目的 評價橈骨遠耑揹側帶血管蒂骨瓣轉位聯閤腕關節外固定支架治療陳舊性舟骨骨摺的中遠期療效.方法 迴顧性分析1995年2月至2006年11月行橈骨遠耑揹側帶血管蒂骨瓣轉位聯閤腕關節外固定支架治療的13例陳舊性舟骨骨摺患者,其中男12例,女1例;平均年齡為29.7歲(21～42歲);9例伴近側極缺血壞死.受傷至手術時間平均為22.2箇月(8～46箇月).血管蒂為1,2區間間伸肌支持帶上血管.固定方式包括螺釘或剋氏針內固定及外固定支架固定.評價方式包括Mayo腕關節臨床功能評分以及影像學評價.結果 13例患者術後穫平均82.9箇月(62～116箇月)隨訪,骨摺均穫愈閤,平均愈閤時間為11.2週(8～15週).Mayo功能評價:優3例,良8例,可2例.末次隨訪時,舟骨角、舟月角、Mayo評分、關節活動度、握力均較術前有顯著提高.結論 以1,2區間間伸肌支持帶上血管為蒂的橈骨遠耑揹側骨瓣轉位聯閤腕關節外固定支架治療陳舊性舟骨骨摺,手術過程相對簡單,療效滿意.使用外固定支架是能夠早期進行功能鍛煉進而改善腕關節功能的重要因素.
목적 평개뇨골원단배측대혈관체골판전위연합완관절외고정지가치료진구성주골골절적중원기료효.방법 회고성분석1995년2월지2006년11월행뇨골원단배측대혈관체골판전위연합완관절외고정지가치료적13례진구성주골골절환자,기중남12례,녀1례;평균년령위29.7세(21～42세);9례반근측겁결혈배사.수상지수술시간평균위22.2개월(8～46개월).혈관체위1,2구간간신기지지대상혈관.고정방식포괄라정혹극씨침내고정급외고정지가고정.평개방식포괄Mayo완관절림상공능평분이급영상학평개.결과 13례환자술후획평균82.9개월(62～116개월)수방,골절균획유합,평균유합시간위11.2주(8～15주).Mayo공능평개:우3례,량8례,가2례.말차수방시,주골각、주월각、Mayo평분、관절활동도、악력균교술전유현저제고.결론 이1,2구간간신기지지대상혈관위체적뇨골원단배측골판전위연합완관절외고정지가치료진구성주골골절,수술과정상대간단,료효만의.사용외고정지가시능구조기진행공능단련진이개선완관절공능적중요인소.
Objective To evaluate the medium-term follow-up outcomes of treatment of chronic scaphoid nonunion with vascularized bone graft based on 1, 2 intercompartmental supraretinacular artery.Methods From February, 1995 to November, 2006, 13 cases of chronic scaphoid nonunion were treated with vascularized bone graft based on 1, 2 intercompartmental supraretinacular artery in our hospital. Nine cases were complicated with avascular necrosis of the proximal pole. The interval between injury and treatment averaged 22. 2 months. The nonunions were stabilized by screw or external fixator. Procedures of arthrolysis were applied and early wrist mobilization was initiated under the protection of external fixator. Radiographic finding and Mayo scoring system were used to evaluate the clinical outcomes. Results The mean time of follow-up was 82.9 months. The union time for the 13 cases averaged 11.2 weeks. At the final follow-up,there were 3 excellent, 8 good and 2 fair evaluations;the range of motion of the wrist, Mayo score, grip strength, intrascaphoid angle and scapholunate angle were significantly improved. Conclusions Chronic scaphoid nonunion can be well treated with vascularized bone graft based on 1, 2 intercompartmental supraretinacular artery. A simple arthrolysis during the procedure can produce satisfactory results. External fixation plays a critical role in early mobilization and functional restoration of the wrist.
