摘要
目的 总结以桡动脉茎突返支为蒂的桡骨茎突骨瓣移位治疗舟骨骨折不愈合的临床效果。方法 2000年3月～2005年6月，对18例舟骨骨折不愈合的患者，以桡动脉茎突返支为蒂在桡骨茎突掀起1．5cm×3．5cm×0．5cm的骨瓣，植入沿舟骨纵轴跨越骨折线所凿同等大小的骨槽内进行治疗。其中男15例，女3例。年龄18～39岁。舟骨腰部骨折11例，近侧1／3骨折7例，其中5例舟骨近端骨折块伴缺血坏死。腕关节活动疼痛，尤以背伸及桡偏时明显，鼻烟窝处有压痛，腕关节活动受限，X线片示10例患者有骨折端硬化及囊性变，骨折线明显加宽。结果 术后18例舟骨骨折均愈合，其中5例合并缺血坏死的舟骨骨折块重新成活，骨折平均愈合时间为4个月。术后获随访1～5年，患者腕关节活动良好，腕背伸时无疼痛，日常生活和工作无影响。结论 采用桡动脉茎突返支为蒂的桡骨茎突骨瓣移位治疗舟骨骨折不愈合及近端骨折块缺血坏死，操作简便，治疗有效，具有一定临床应用价值。
Objective To report the clinical outcome of the transposition of the radial styloid bone flap pedicled on the recurrent branch of the radial artery in the treatment of scaphoid nonunion. Methods From March 2000 to June 2005, the procedure was done in 18 patients with scaphoid nonunion, a small bone flap（1.5 cm × 3.5 cm × 0.5 cm）pedicled on the recurrent branch of radial artery to the styloid process was raised from the radial styloid process and grafted into the corresponding slot chiseled along the vertical axis of scaphoid crossing the fracture line. Of 18 patients, 15 were males and 3 were females, aging 18-39 years. The locations were lumbar scaphoid in 11 patients and proximal scaphoid in 7 patients,among whom 5 had presented avascular necrosis in the proximal fragments of the scaphoid. Pain occurred in the act of wrist motion, and became obvious in the case of dorsiextension and radial deviation. Compression pain was observed in the stuff nest. The wrist joint activity is subjected to limit. The X-ray showed hardening and cystic degereration at fracture end and obviously widening fracture line. Results The scaphoid fracture healed in all 18 cases, the 5 proximal scaphoid fracture fragments which had previously been necrosed survived, a mean healing time of scaphoid was 4 months. A follow-up of 1 to 5 years revealed normal wrist motion without pain in all cases. The life and job was good every day. Conclusion Transposition of the bone flap pedicled on the recurrent branch of the radial artery to the scaphoid is relatively simple and can effectively treat scaphoid nonunion and avascular necrosis with a great value in clinical application.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2006年第11期1070-1072,共3页
Chinese Journal of Reparative and Reconstructive Surgery
