头状骨移位治疗月骨无菌性坏死

Capitates Transposition for Treatment of Kienbcks Disease in Advanced Stage

目的：介绍以骨间前动脉背侧支为蒂的头状骨移位治疗晚期月骨无菌性坏死。方法：对7例Lichtman分Ⅲ、Ⅳ期月骨无菌性坏死患者采用坏死月骨摘除,以骨间前动脉背侧支为蒂的头状骨移位替代坏死月骨。结果：术后随访1-5年,平均32个月,移位头状骨有可靠血运,6例腕痛消失,1例仍有轻度腕痛,优良率100%。结论：应用该法替代月骨支撑腕关节,符合腕关节功能解剖,是治疗Ⅲ、Ⅳ期月骨无菌性坏死的有效方法。

Objective： To introduce a surgical procedure of capitates transposition based on the dorsal branch of the anterior interosseous artery for treatment of Kienbǒcks disease in advanced stage. Methods： Sseven patients with Kienbǒcks disease of stage Ⅲ and Ⅳ were involved in this study. The necroses lunette was excised with capitates transposition based on the dorsal branch of the anterior interosseous artery. Results： All patients were followed up for 1-5 years, with an average of 32 months. The transposition capitates had a reliable blood supply. Relief of pain was obtained in sixteen cases, and two patients experienced mild pain. All patients returned to their normal wrist functions. Conclusion：This procedure can replace the lunette for sustaining function of wrist, and is in accordance with the functional anatomy of wrist. It is an effective method to treat Kienbǒcks disease of stage Ⅲ and Ⅳ.