■小骨舟骨近端骨不连的临床挑战受到碎片大小的影响,血管受损,通过肩胛骨间韧带(SLIL)施加的变形力,和潜在的关节碎片。用于近端极重建的骨软骨自体移植选择包括内侧股骨滑车,肋软骨肋骨,或者近端哈密特。本研究报告了接受近端骨软骨自体移植重建治疗的患者的临床结果。
■一项回顾性研究确定了2个机构接受该手术治疗的患者,并进行了至少6个月的随访。临床结果包括视觉模拟疼痛评分,12项简短形式调查,手臂的缩写残疾,肩膀,和手(QuickDASH)得分,手腕和前臂的活动范围(ROM),射线照相评估,和并发症。我们回顾了这些结果,并将其与当前发表的文献进行了比较。
■4名患者(平均年龄:24岁,包括75%的男性),平均随访12.8个月(范围:6-20个月)。在所有病例中,到12周时都确定了射线照相结合(范围,10-12).在最后的随访中,与对侧相比,平均腕部ROM为67.5%的屈伸和100%的内旋。平均QuickDASH得分为17.6(SD,13).未发现并发症。
■使用自体近端has骨软骨移植进行的近端舟骨骨不连重建显示出令人鼓舞的临床和影像学结果。近旁的玛瑙收获涉及最小的供体部位发病率,而没有远处的手术部位。使用与近端舟骨形态相似的骨软骨移植物,不需要显微外科技术,并允许使用掌侧头状韧带重建SLIL。
UNASSIGNED: Small proximal pole scaphoid nonunions present a clinical challenge influenced by fragment size, vascular compromise, deforming forces exerted through the scapholunate interosseous ligament (SLIL), and potential articular fragmentation. Osteochondral autograft options for proximal pole reconstruction include the medial femoral trochlea, costochondral rib, or proximal hamate. This study
reports the clinical outcomes of patients treated with proximal hamate osteochondral autograft reconstruction.
UNASSIGNED: A retrospective review identified patients treated with this surgery from 2 institutions with a minimum 6-month follow-up. Clinical outcomes included the Visual Analog Dcale pain score, 12-item Short-Form survey, abbreviated Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, wrist and forearm range of motion (ROM), radiographic assessment, and complications. We reviewed and compared these outcomes with those of the current published literature.
UNASSIGNED: Four patients (mean age: 24 years, 75% men) with a 12.8-month average follow-up (range: 6-20 months) were included. Radiographic union was identified in all cases by 12 weeks (range, 10-12). The average wrist ROM was 67.5% flexion/extension and 100% pronation/supination compared with the contralateral side at the final follow-up. The mean QuickDASH score was 17.6 (SD, 13). No complications were identified.
UNASSIGNED: Proximal pole scaphoid nonunion reconstruction using autologous proximal hamate osteochondral graft demonstrated encouraging clinical and radiographic outcomes. Proximal hamate harvest involves minimal donor site morbidity without a distant operative site, uses an osteochondral graft with similar morphology to the proximal scaphoid, requires no microsurgical technique, and permits reconstruction of the SLIL using the volar capitohamate ligament.