筋膜血管蒂骨瓣植骨治疗陈旧性腕舟骨骨折

Treatlnent of Old Fracture of Carpal Scaphoidwith Fascial Vasculo-pedicled Bone Flap Graft

介绍一种筋膜血管蒂骨瓣植骨治疗陈旧性腕舟骨骨折的新方法。取腕桡侧切日，保留挠侧深筋膜及侧副韧带在桡骨茎突上的附着处，在腕舟骨骨折线的近端切除桡骨茎突，使其成为带有０．５ｃｍ宽含有微小动脉的带蒂骨块，在舟骨背侧以骨折线为中心凿槽，修整桡骨茎突骨块与骨槽大小一致后嵌入槽内。适用于陈旧性腕舟状骨骨折并发桡舟关节创伤性关节炎，桡骨茎突顶压骨折线以及骨折断端有硬化和囊性改变的病例。

AbstractThe author described a new method of fascialvasculo-pedicled bone flap graft for the treatment ofold fractures of the carpal scaphoid bone, The insicionwas made over the radial aspect of the wrist.The deepradial fascia and collateral ligament were left intact atthe radial stvloid.The radial stvloid was resected closeto the proximal fracture line of the scaphoid bone andit was made into a small bone fragment with a Widthof 0.5cm cmd anarteriolar pedicle. A slot centered atthe fracture line was formed withsmall bone chisels onthe dorsal aspect of the navicular bone;the small bonefragment was remodeled to fit into the slot at thescaphoid bone,This procedure is especially useful forthe old fractures of the carpal scaphoid associated withosteoarthritis, with compression of the fracture lineby the radial styloid resulting in sclerosis and cysticchanges over the fractured fragments. The authorreported his experience in 12 cases treated with theabove mentioned method,all with satisfactory results.