Herbert螺钉联合带蒂桡骨骨瓣移植治疗腕舟状骨骨不连

Herbert screw combined with vascularized fascial pedicled bone flap of radial styloid process for treatment of carpal scaphoid nonunion

目的探讨Herbert螺钉联合带血管筋膜蒂桡骨茎突骨瓣治疗腕舟状骨骨不连的临床疗效。方法采用Herbert螺钉固定联合带血管筋膜蒂桡骨茎突骨瓣治疗我院骨科自2010年9月~2016年1月收治的腕舟状骨骨不连患者25例。结果所有的患者平均随访5~24个月,骨折均愈合,骨折愈合时间是(12.7±2.1)周,使用改良Mayo腕关节评分评价腕关节功能,优秀16例,良好5例,一般3例,较差1例。结论对于腕舟状骨骨不连的患者,Herbert螺钉联合带血管筋膜蒂桡骨茎突骨瓣治疗腕舟状骨骨不连是一种有效且可行的方法。

Objective To explore the clinical effect of Herbert screw combined with vascularized fascial pedicled bone flap of radial styloid process for treatment of carpal scaphoid nonunion. Methods From Sep 2010 to Jan 2016, 25 patients with carpal scaphoid nonunion were treated with fixation by Herbert screws and combined with vascularized fascial pedi- cled bone flap of radial styloid process in the department of orthopaedics in our hospital. Results All the patients were followed up, and the duration ranged from 5 to 24 months. All the fractures are healed, the bone union time was （12.7±2.1） weeks. They were evaluated with modified Mayo wrist score system, 16 patients got an excellent result, 5 good, 3 normal and 1 poor. Conclusion Herbert screw combined with vascularized fascial pedicled bone flap of radial styloid process can be a effective and feasible approach to the treatment of carpal scaphoid nonunion.