应用带血运桡骨茎突骨瓣治疗腕舟骨骨折和骨缺损

Grafting of radial styloid bone flap with vascular pedicle in treatment of scaphoid fractures

目的探讨以桡动脉返支为蒂桡骨茎突骨瓣治疗腕舟骨骨折和骨缺损的治疗效果。方法对19例第2、3型腕舟骨骨折患者行桡动脉返支为蒂的桡骨茎突骨瓣移植，克氏针交叉加压固定治疗舟骨嵌入骨折13例；同时应用带血运的桡骨瓣重建因磨损、吸收所致的舟状骨缺损6例。结果19例腕舟骨骨折和骨缺损患者，X线示骨折全部骨性愈合，舟状骨形态恢复正常。采用改良Gartland—Werley腕关节功能评分标准进行评估：优16例，良2例，中1例。结论桡动脉返支为蒂桡骨茎突骨瓣移植治疗腕舟骨骨折和骨缺损效果肯定。

Objective To investigate the methods and curative effects of treating scaphoid fracture and osteohalisteresis. Methods 19 cases with unstable scaphoid fracture（type2,3） were treated by grafting of radial styloid bone flap with vascular pedicle and internal fixation. 13 cases of flesh scaphoid fracture were treated by crossed Kirschner＇ s Nails pressing fixation. 6 old scaphoid fracture cases with scaphoid osteohalisteresis were treated by grafting of radial styloid bone flap with vascular pedicle and internal fixation. Results 19 cases with unstable scaphoid fracture and osteohalisteresis were followed up and proved by X-ray, all patients were healed. Conclusion Grafting of radial styloid bone flap with vascular pedicle is an effective method for treatment of fresh unstable scaphoid fractures and old scaphoid fracture with osteohalisteresis.