带第二掌背动脉蒂掌骨膜瓣移植治疗腕舟骨骨折不愈合

GRAFTING OF METACARPAL PERIOSTEUM ISLAND FLAPS WITH THE SECONDARY DORSAL METACARPAL ARTERY IN TREATMENT OF WRIST SCAPHOID FRACTURE NONUNION

目的：介绍治疗腕舟骨骨折不愈合的一种新手术方法，丰富治疗腕舟骨骨折不愈合的手术术式。方法：切除腕舟骨骨折不愈合之硬化骨，以〔形钉固定舟骨骨折端，用带第２掌背动脉蒂掌骨骨膜瓣翻转移植治疗腕舟骨骨折不愈合１１例。结果：术后６～８周骨折初步愈合，３～４个月骨折完全愈合，随访９～１５个月腕关节活动正常无痛。结论：第二掌背动脉位置恒定，血管蒂长、口径粗、游离安全容易，血供充分，能有效的促进舟骨骨折愈合。

Objective:An new operation method had been introduced to treat wrist scaphoid fracture nonunion The operation technique of treatment wirst scaphoid fracture nonunion had been enrichMethods:The harden bone of wrist scaphoid fracture nonunion is excised 〔 shape nail fixed scaphoid fracture end The 11 cases of wirst scaphoid fracture nonunion had been treated in overturn graft of metacarpal periosteum island flaps with the secondary dorsal metacarpal artery Results:The fracture is initial stage union in 6￣8 weeks after operationFracture is complete union in 3￣4 month after operationWrist movement is normal to feel no pain in follow up 9￣15 monthConclusions:The place of secondary dorsal metacarpal artery is constantBlood vessel pedicle is longblood vessel calibre is wied,Separate of blood vessel pedicel is easy and safeBlood circulation is enrichThe graft of mtacarpal periosteum island flaps with secondary dorsal metacarpal artery can promote scaphoid fracture union