PDF(Sci-hub)
Abstract：
UNASSIGNED: Scaphoid nonunion remains a major problem in hand surgery. The 1,2 intercompartmental supraretinacular artery flap (1,2 ICSRA), as first described by Zaidemberg et al, is widely used with reported union rates of approximately 80%. However, its use is limited in the case of associated carpal collapse as in dorsal intercalated segmental instability (DISI) and humpback deformity. In this study, we present a novel approach to this flap enabling the correction of associated carpal collapse.
UNASSIGNED: Between 2006 and 2015, 9 patients with scaphoid nonunion or delayed union with carpal collapse were treated with a vascularized bone flap based on the 1,2 ICSRA using a combined volar and dorsal approach. Immobilization in a short-arm cast was applied for 8 weeks. Union rates, correction of DISI and humpback deformity, as well as clinical end points were noted. In addition, scapholunate (SL) angles were measured using 2 accepted radiological techniques, employing either the scaphoid midline axis or its proximal radiological landmarks as a reference.
UNASSIGNED: All cases united and a median time to bone consolidation of 4 months (range, 2-5 months) was observed. Preoperative DISI deformities (n = 4) were corrected in all patients. Humpback deformities (n = 5) were also corrected. Two patients had repeat surgery: one for K-wire removal after bony consolidation and the other for neuropathic pain.
UNASSIGNED: The 1,2 ICSRA bone flap is a reliable treatment for scaphoid nonunion associated with carpal collapse. This combined volar and dorsal approach permits the correction of DISI and humpback deformity without compromising the scaphoid vascular supply, which eliminates the need to use free bone flaps from other sites. In this series, we observed a 100% union rate. Two patients required reoperation for symptomatic hardware and dorsal wrist pain linked to superficial neuritis.
UNASSIGNED: Therapeutic IV.
UNASSIGNED: Between 2006 and 2015, 9 patients with scaphoid nonunion or delayed union with carpal collapse were treated with a vascularized bone flap based on the 1,2 ICSRA using a combined volar and dorsal approach. Immobilization in a short-arm cast was applied for 8 weeks. Union rates, correction of DISI and humpback deformity, as well as clinical end points were noted. In addition, scapholunate (SL) angles were measured using 2 accepted radiological techniques, employing either the scaphoid midline axis or its proximal radiological landmarks as a reference.
UNASSIGNED: All cases united and a median time to bone consolidation of 4 months (range, 2-5 months) was observed. Preoperative DISI deformities (n = 4) were corrected in all patients. Humpback deformities (n = 5) were also corrected. Two patients had repeat surgery: one for K-wire removal after bony consolidation and the other for neuropathic pain.
UNASSIGNED: The 1,2 ICSRA bone flap is a reliable treatment for scaphoid nonunion associated with carpal collapse. This combined volar and dorsal approach permits the correction of DISI and humpback deformity without compromising the scaphoid vascular supply, which eliminates the need to use free bone flaps from other sites. In this series, we observed a 100% union rate. Two patients required reoperation for symptomatic hardware and dorsal wrist pain linked to superficial neuritis.
UNASSIGNED: Therapeutic IV.
摘要：
未经证实：肩关节骨不连仍然是手外科的主要问题。1,2室间视网膜上动脉皮瓣（1,2ICSRA），正如Zaidemberg等人首先描述的那样，被广泛使用，据报道工会率约为80%。然而,在相关的腕骨塌陷的情况下，如背侧插层节段不稳定（DISI）和驼背畸形，其使用受到限制。在这项研究中,我们提出了一种新颖的方法来纠正这种皮瓣，从而可以纠正相关的腕骨塌陷。
UNASSIGNED：在2006年至2015年之间，采用掌侧和背侧联合入路基于1,2ICSRA的血管化骨瓣治疗了9例舟骨骨不连或腕骨塌陷延迟愈合的患者。应用短臂石膏固定8周。工会费率，矫正DISI和座头鲸畸形，并记录了临床终点.此外,使用2种公认的放射学技术测量了肩胛骨（SL）角度，使用舟骨中线或其近端放射学标志作为参考。
UNASSIGNED：所有病例合并，至骨巩固的中位时间为4个月（范围，2-5个月）。所有患者的术前DISI畸形（n=4）均得到纠正。座头鲸畸形（n=5）也得到了纠正。两名患者进行了重复手术：一名用于骨巩固后去除K线，另一名用于神经性疼痛。
UNASSIGNED：1,2ICSRA骨瓣是治疗与腕骨塌陷相关的舟骨骨不连的可靠方法。这种掌侧和背侧相结合的方法可以在不损害舟骨血管供应的情况下矫正DISI和座头畸形。这消除了从其他部位使用自由骨瓣的需要。在这个系列中,我们观察到100%的工会率。两名患者需要再次手术治疗，原因是有症状的硬件和与浅表神经炎有关的腕背疼痛。
未经批准：治疗IV。
UNASSIGNED：在2006年至2015年之间，采用掌侧和背侧联合入路基于1,2ICSRA的血管化骨瓣治疗了9例舟骨骨不连或腕骨塌陷延迟愈合的患者。应用短臂石膏固定8周。工会费率，矫正DISI和座头鲸畸形，并记录了临床终点.此外,使用2种公认的放射学技术测量了肩胛骨（SL）角度，使用舟骨中线或其近端放射学标志作为参考。
UNASSIGNED：所有病例合并，至骨巩固的中位时间为4个月（范围，2-5个月）。所有患者的术前DISI畸形（n=4）均得到纠正。座头鲸畸形（n=5）也得到了纠正。两名患者进行了重复手术：一名用于骨巩固后去除K线，另一名用于神经性疼痛。
UNASSIGNED：1,2ICSRA骨瓣是治疗与腕骨塌陷相关的舟骨骨不连的可靠方法。这种掌侧和背侧相结合的方法可以在不损害舟骨血管供应的情况下矫正DISI和座头畸形。这消除了从其他部位使用自由骨瓣的需要。在这个系列中,我们观察到100%的工会率。两名患者需要再次手术治疗，原因是有症状的硬件和与浅表神经炎有关的腕背疼痛。
未经批准：治疗IV。
