摘要
目的探讨应用AO加压螺钉联合桡骨远端骨膜瓣治疗舟骨陈旧性骨折的疗效。方法自2009年9月至2015年12月，对17例舟骨骨不连患者采用加压螺钉联合桡骨远端骨膜瓣进行治疗。腰部骨不连11例，近端骨不连6例；Herbert C型10例，D型7例；5例伴有近端骨折块缺血性坏死，2例伴有轻度桡骨茎突关节炎。骨膜瓣均以第1、2-伸肌腱鞘支持带上动脉（1，2ICSRA）为血管蒂逆行转移。术后定期复查X线片、CT等，随访骨折愈合时间、腕痛、腕关节活动度、握力等情况。结果术后17例获得6～20个月的随访，平均13．5个月，所有骨折均骨性愈合，平均愈合时间为12周，腕痛基本消失。按Krimmer腕关节功能评分法评定：优u例，良5例，可1例。结论AO加压螺钉联合桡骨垂端骨膜瓣能促进舟骨骨不连的愈合，特别对HerbertC型、D型是一种有效的治疗选择。
Objective To study the efficacy of AO lag screw combined with distal radius periosteal flap in the treatment of scaphoid fracture nonunion. Methods From September 2009 to December 2015, 17 scaphoid nonunion cases, consisted of 11 waist fracture and 6 proximal fracture nonunion, were treated with AO lag screw combined with distal radius periosteal flap. In these cases, 10 were Herbert C, while 7 were Herbert D. Five cases were combined with proximal ischemic necrosis and 2 cases with styloid arthritis. The distal radius periosteal flap was pedicled with 1,2 ICSRA. Patients had regular X-ray and CT and were evaluated for healing time, wrist pain and range of motion postoperatively. Results These patients were follow-up for 6 to 20 months. The mean follow up time was 13.5 months. The scaphoid nonunion was healed in all the cases. The average time of healing was 12 weeks and wrist pain almost disappeared. According to modified Krimmer wrist scoring system, the results were rated as excellent in 11 cases, good in 5 cases and fair in 1 case. Conclusion AO lag screw combined with distal radius periosteal flap can promote the healing of scaphoid nonunion, especially for Herbert C and D type cases.
出处
《中华手外科杂志》
CSCD
北大核心
2017年第2期106-108,共3页
Chinese Journal of Hand Surgery
关键词
舟骨
骨折
不愈合
骨膜瓣
骨折固定术
Scaphoid bone
Fractures,ununited
Periosteal flap
Fracture fixation
