带血管蒂的桡骨瓣植入治疗陈旧性腕舟骨骨折

Grafting of radial bone flap with vascular pedicle for treatment of old scaphoid fracture

目的 探讨治疗陈旧性舟状骨骨折的手术方法。方法 对 3 6例陈旧性舟状骨骨折 ,采用带血管蒂桡骨瓣加植骨术治疗。结果 3 6例骨折全部骨性愈合。骨折愈合时间 ,术后 8周 2 4例 ,10周 8例 ,12周 2例 ,15周 2例。 3 5例腕关节功能恢复达健侧标准 ,活动时无疼痛。 1例较术前有改善 ,活动时疼痛。结论 该术式手术操作简单 ,舟状骨骨折端植入的带血管蒂骨瓣形成“骨桥” ,与植入的松质骨及舟状骨建立血供 ,可缩短骨折愈合时间及提高骨折愈合率 。

ObjectiveTo introduce the surgical procedures for treatment of old scaphoid fracture. Methods36 cases of old scaphoid frac tures were treat ed with vascularized bone grafting from the distal radius plus cancellous bone g rafting.ResultsAll fractures healed. Bone union was seen 8 weeks postope ratively in 24 patients, 10 weeks in 8 patients, 12 weeks in 2 patients, and 15 weeks in 2 patients. 35 patients restored normal wrist function and had no pain, while 1 patient had obvious improvement and only pain at motion. Conclu sionThis operative technique is simple. The vascularized radial bone g raft served as 'bone bridge' to introduce blood supply with the cancellous bon e graft and scapho id. It thus can improve bone healing with a reduced healing time and increased h ealing rate. This surgical procedure is an effective way to treat old scaphoid f racture.