CAJ | 학술논문

目的探讨腕舟骨骨不连的手术治疗方法和临床效果.方法 2007年1月至2014年9月,我院收治16例腕舟骨骨不连患者,采用桡背侧入路带桡骨茎突返支血管蒂桡骨瓣转移治疗腕舟骨骨不连8例,其中合并桡骨茎突切除手术4例;采用桡掌侧入路旋前方肌桡骨瓣转移4例,采用桡掌侧入路吻合血管游离髂骨瓣移植手术4例.结果本组16例均获得随访,随访时间6～40个月,愈合时间3～8个月,骨性愈合率87.5％,腕关节功能恢复,无腕关节不稳发生,其中2例手握力差,腕关节疼痛,疗效较差,优良率87.5％.结论根据每个患者舟骨骨不连的具体特点,骨坏死的部位、程度、骨折的稳定性以及有无驼背畸形、腕骨塌陷、有无创伤性关节炎、局部软组织创伤程度等,制定个性化手术治疗方案,各手术方法疗效可靠,临床效果较好.
목적 탐토완주골골불련적수술치료방법화림상효과.방법 2007년1월지2014년9월,아원수치16례완주골골불련환자,채용뇨배측입로대뇨골경돌반지혈관체뇨골판전이치료완주골골불련8례,기중합병뇨골경돌절제수술4례;채용뇨장측입로선전방기뇨골판전이4례,채용뇨장측입로문합혈관유리가골판이식수술4례.결과 본조16례균획득수방,수방시간6～40개월,유합시간3～8개월,골성유합솔87.5％,완관절공능회복,무완관절불은발생,기중2례수악력차,완관절동통,료효교차,우량솔87.5％.결론 근거매개환자주골골불련적구체특점,골배사적부위、정도、골절적은정성이급유무타배기형、완골탑함、유무창상성관절염、국부연조직창상정도등,제정개성화수술치료방안,각수술방법료효가고,림상효과교호.
Objective To investigate the operation method for carpal scaphoid bone nonunion and its clinical effect.Methods From January,2007 to September,2014,16 patients with scaphoid nonunion were hospitalized into our hospital.8 were treated by radial dorsal approach with radial styloid recurrent branch of radial vascular pedicle flap transfer,of which 4 complicated with excision of radial styloid operation;4 radial volar pronator radial bone flap metastasis;and 4 radial volar vascularized free iliac bone flap transplantation operation.Results All the 16 cases were followed up for 6-40 months follow-up;the healing time was 3-8 months;the bone healing rate was 87.5％;wrist joint function recovered;no carpal instability occurred;2 patients' hand grip strength was poor;wrist joint pained;the treatment for pain wasn't effective;the excellent and good rate was 87.5％.Conclusions Developing individualized operation treatment scheme according to the specific characteristics of each patient with nonunion of scaphoid bone——bone necrosis location and degree,fracture stability,having kyphosis or not,carpal collapse,having traumatic arthritis or not,local soft tissue trauma degree,etc.is reliably and clinically effective.