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Abstract：
Background Treatment of post-traumatic osteochondral defects in the radiocarpal and distal radioulnar joint with nonvascularized metatarsal articular bone grafting is an option to restore the joint (cartilage) surface and wrist function. Purpose To evaluate the clinical midterm results of 10 consecutive patients who were treated with a nonvascularized metatarsal bone graft for cartilage bone defects of the lunate facet, scaphoid facet, sigmoid notch, or the radial part of the ulnar head. Patients and Methods Patients with isolated osteochondral defects of the lunate facet, scaphoid facet, sigmoid notch, or radial part of the ulnar head, respectively, as a result of wrist trauma were retrospectively identified in a prospectively collected database. The patients symptoms were limited wrist motion and/or pain. Clinical results and complications were extracted from patient\'s medical files and two questionnaires consisting of the Patient-Rated Wrist Evaluation and additional questions regarding patient satisfaction and return to work and/or hobby. Results Minor complications occurred in three cases and required surgery. In five cases an acceptable donor site foot morbidity was seen at 1 year. One patient was not satisfied due to persistent wrist pain despite adequate range of motion. One patient could not return to its prior work. Another patient could not resume its hobby. Conclusion Retrospective evaluation of 10 cases with resurfacing of the scaphoid facet, sigmoid notch, and/or lunate facet, or radial part of the ulnar head has shown that osseointegration was possible without a vascular pedicle to the graft in all cases with a (mean) follow-up of 5 years. This technique may become an alternative treatment when implants become less available. Level of Evidence Level III.
摘要：
背景：采用非血管化跖骨关节植骨治疗桡骨和尺尺关节的创伤后骨软骨缺损是恢复关节（软骨）表面和腕关节功能的一种选择。目的评价连续10例接受非血管化meta骨移植治疗的月关节软骨骨缺损患者的临床中期结果。舟骨小面,乙状缺口,或尺骨头的径向部分。患者和方法月骨软骨缺损的患者，舟骨小面,乙状缺口,或尺骨头的径向部分，分别,在前瞻性收集的数据库中对腕部创伤的结果进行了回顾性识别.患者症状为手腕活动受限和/或疼痛。从患者的医疗档案和两份问卷中提取临床结果和并发症，问卷包括患者评分腕部评估以及有关患者满意度和重返工作和/或爱好的其他问题。结果3例发生轻微并发症,需手术治疗。在5例病例中，在1年时观察到可接受的供体部位足部发病率。尽管有足够的活动范围，但由于持续的腕部疼痛，一名患者仍不满意。一名患者无法恢复其先前的工作。另一位患者无法恢复其爱好。结论对10例舟骨小关节置换术患者进行回顾性评估，乙状缺口,和/或月面，尺骨头的或radial部表明，在所有情况下，在（平均）随访5年的情况下，在没有血管蒂的情况下，骨整合是可能的。当植入物变得不可用时,该技术可成为替代治疗。证据等级III级。
