PDF(Pubmed)
Abstract：
UNASSIGNED: The use of the dorsal hamate as a free osteochondral bone graft or vascularized bone flap has become the mainstay for large, comminuted middle phalanx volar lip fractures. To date, few studies have been conducted in the assessment of donor site morbidity for the hemi-hamate graft or flap, and none have discussed modes of repair or reconstruction of this donor site.
UNASSIGNED: A retrospective analysis of 14 hemi-hamate arthroplasty (HHA) procedures, including 6 vascularized and 8 non-vascularized grafts, from two surgeons was performed. Four hamate defect reconstruction techniques were utilized: no formal reconstruction, autologous bone grafting, gel foam, or synthetic bone substitute. The dorsal capsule was repaired with either extensor retinaculum grafting or by direct closure. Wrist range of motion, pain scores, and radiographic alignment were assessed.
UNASSIGNED: At 6 months follow-up, all patients achieved full, pain-free wrist motion compared to the uninjured side, with visual analog scale pain scores of 0. Serial radiographs showed maintained carpal alignment without instability or subluxation. No differences based on the hamate defect reconstruction method or capsular repair technique was demonstrated.
UNASSIGNED: Safe return to pain free, unrestricted wrist function is achievable after HHA, regardless of hamate donor site management. Adequate dorsal capsular repair appears critical to prevent instability. Further study is needed to compare techniques, but choice may be guided by surgeon preference in the absence of clear evidence.
UNASSIGNED: A retrospective analysis of 14 hemi-hamate arthroplasty (HHA) procedures, including 6 vascularized and 8 non-vascularized grafts, from two surgeons was performed. Four hamate defect reconstruction techniques were utilized: no formal reconstruction, autologous bone grafting, gel foam, or synthetic bone substitute. The dorsal capsule was repaired with either extensor retinaculum grafting or by direct closure. Wrist range of motion, pain scores, and radiographic alignment were assessed.
UNASSIGNED: At 6 months follow-up, all patients achieved full, pain-free wrist motion compared to the uninjured side, with visual analog scale pain scores of 0. Serial radiographs showed maintained carpal alignment without instability or subluxation. No differences based on the hamate defect reconstruction method or capsular repair technique was demonstrated.
UNASSIGNED: Safe return to pain free, unrestricted wrist function is achievable after HHA, regardless of hamate donor site management. Adequate dorsal capsular repair appears critical to prevent instability. Further study is needed to compare techniques, but choice may be guided by surgeon preference in the absence of clear evidence.
摘要：
■使用背骨作为游离骨软骨骨移植物或血管化骨瓣已成为大型骨瓣的支柱，粉碎性中指骨掌侧唇骨折。迄今为止,很少有研究在评估供区发病率的半哈密特移植物或皮瓣，没有人讨论过这个供体部位的修复或重建模式。
■对14例半髋关节置换术（HHA）的回顾性分析，包括6个血管化移植物和8个非血管化移植物，两名外科医生进行了手术。使用了四种哈玛特缺损重建技术：没有正式重建，自体骨移植,凝胶泡沫，或合成骨替代物.背囊通过伸肌支持带移植或直接闭合来修复。手腕运动范围,疼痛评分,和射线照相对齐进行了评估。
■随访6个月时，所有患者都达到了完全，与未受伤的一侧相比，无痛的手腕运动，用视觉模拟量表疼痛评分为0。连续X光片显示腕骨对齐保持，没有不稳定或半脱位。没有证明基于hamate缺损重建方法或囊膜修复技术的差异。
■安全恢复无痛，HHA后可实现无限制的手腕功能，不管阻碍捐赠现场管理。适当的背侧囊修复对于防止不稳定至关重要。需要进一步的研究来比较技术，但在没有明确证据的情况下，选择可能会受到外科医生偏好的指导。
■对14例半髋关节置换术（HHA）的回顾性分析，包括6个血管化移植物和8个非血管化移植物，两名外科医生进行了手术。使用了四种哈玛特缺损重建技术：没有正式重建，自体骨移植,凝胶泡沫，或合成骨替代物.背囊通过伸肌支持带移植或直接闭合来修复。手腕运动范围,疼痛评分,和射线照相对齐进行了评估。
■随访6个月时，所有患者都达到了完全，与未受伤的一侧相比，无痛的手腕运动，用视觉模拟量表疼痛评分为0。连续X光片显示腕骨对齐保持，没有不稳定或半脱位。没有证明基于hamate缺损重建方法或囊膜修复技术的差异。
■安全恢复无痛，HHA后可实现无限制的手腕功能，不管阻碍捐赠现场管理。适当的背侧囊修复对于防止不稳定至关重要。需要进一步的研究来比较技术，但在没有明确证据的情况下，选择可能会受到外科医生偏好的指导。
