中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2010年
8期
702-705
,共4页
舟骨%骨折固定术,内%外固定器%骨瓣移植
舟骨%骨摺固定術,內%外固定器%骨瓣移植
주골%골절고정술,내%외고정기%골판이식
Scaphoid bones%Fracture fixation,internal%External fixators%Bone transplantation
目的 评价桡骨远端背侧带血管蒂骨瓣转位治疗陈旧性舟骨骨折的中远期疗效.方法 回顾性分析1995-2006年行桡骨远端背侧带血管蒂骨瓣转位治疗的13例陈旧性舟骨骨折,其中9例伴近侧极缺血坏死.血管蒂为1,2区间间伸肌支持带上血管.固定方式包括螺钉内固定及外支架固定.评价内容包括Mayo腕关节临床功能评分以及影像学评价.结果 手术距受伤时间平均22.2个月,平均随访76.6个月.骨折愈合13例,平均愈合时间11.2周.功能评价:优3例,良8例,可2例.末次随访时,腕关节功能评分、关节活动度、握力均较术前有显著提高.舟骨角以及舟月角明显改善.结论 桡骨远端背侧带血管蒂骨瓣转位治疗陈旧性舟骨骨折手术过程相对简单,疗效满意.术中予腕关节松解,术后腕关节在外支架的保护下进行早期功能锻炼可促进关节功能的恢复.
目的 評價橈骨遠耑揹側帶血管蒂骨瓣轉位治療陳舊性舟骨骨摺的中遠期療效.方法 迴顧性分析1995-2006年行橈骨遠耑揹側帶血管蒂骨瓣轉位治療的13例陳舊性舟骨骨摺,其中9例伴近側極缺血壞死.血管蒂為1,2區間間伸肌支持帶上血管.固定方式包括螺釘內固定及外支架固定.評價內容包括Mayo腕關節臨床功能評分以及影像學評價.結果 手術距受傷時間平均22.2箇月,平均隨訪76.6箇月.骨摺愈閤13例,平均愈閤時間11.2週.功能評價:優3例,良8例,可2例.末次隨訪時,腕關節功能評分、關節活動度、握力均較術前有顯著提高.舟骨角以及舟月角明顯改善.結論 橈骨遠耑揹側帶血管蒂骨瓣轉位治療陳舊性舟骨骨摺手術過程相對簡單,療效滿意.術中予腕關節鬆解,術後腕關節在外支架的保護下進行早期功能鍛煉可促進關節功能的恢複.
목적 평개뇨골원단배측대혈관체골판전위치료진구성주골골절적중원기료효.방법 회고성분석1995-2006년행뇨골원단배측대혈관체골판전위치료적13례진구성주골골절,기중9례반근측겁결혈배사.혈관체위1,2구간간신기지지대상혈관.고정방식포괄라정내고정급외지가고정.평개내용포괄Mayo완관절림상공능평분이급영상학평개.결과 수술거수상시간평균22.2개월,평균수방76.6개월.골절유합13례,평균유합시간11.2주.공능평개:우3례,량8례,가2례.말차수방시,완관절공능평분、관절활동도、악력균교술전유현저제고.주골각이급주월각명현개선.결론 뇨골원단배측대혈관체골판전위치료진구성주골골절수술과정상대간단,료효만의.술중여완관절송해,술후완관절재외지가적보호하진행조기공능단련가촉진관절공능적회복.
Objective To evaluate the medium and long term follow-up results of vascularized bone grafts dorsal distal radius in treatment of chronic scaphoid nonunion. Methods A retrospective study was carried out in 13 patients with chronic scaphoid nonunion treated with vascularized bone grafts dorsal distal radius in our hospital from 1995 to 2006. Nine patients were accompanied by avascular necrosis of the proximal pole. The vascular pedicle was 1,2 intercompartmental supraretinacular artery. The nonunion was stabilized by screws or external fixators. Radiographic finding and Mayo scoring system on wrist mobilization were used to evaluate the clinical outcomes. Results The interval between injury and treatment was average 22.2 months. All patients were followed up for average 76.6 months, which showed that 12 patients obtained fracture union, with average union time of 11.2 weeks. Functional evaluation results were defined as excellent in three patients, good in eight and fair in two. The last follow-up revealed significant improvement of the range of motion of the wrist, Mayo scores, grip strength, intrascaphoid angles and scapholunate angles. Conclusions Vascularized bone grafts from dorsal distal radius has relatively surgical procedure and can achieve satisfactory results in management of scaphoid nonunion. The perioperative arthrolysis and early postoperative mobilization of the wrist under exernal fixation play critical role in restoration of wrist function.
