目的:分析舟骨骨不连的治疗结果,但是没有明显的畸形或塌陷,使用1,2室间视网膜上动脉(1.2ICSRA)的血管化骨移植物和随后的骨合成。
方法:对10例X线诊断为骨不连的男性患者进行了回顾性研究。功能,疼痛使用视觉模拟评分(VAS),握力,患者满意度和重新引入工作生活,治疗后采用QuickDASH和May特异性腕关节量表进行评估。通过射线照相术检查移植物的整合。
结果:平均随访31.4个月,90%的问卷令人满意。VAS降低了4.6点,屈伸肌迁移率增加为5°。平均5.5个月,总移植物巩固率达到40%。
结论:一些研究表明,使用血管化骨移植物与非血管化骨移植物的效果更好。根据Zaidemberg在1991年的描述,具有1.2ICSRA动脉的血管化移植物,桡骨远端,目前已被广泛用于治疗舟骨骨不连。
结论:我们的结果与文献相当,因此使用1.2ICSRA的血管移植物和Herbert型螺钉的骨接合术,可能是一种替代治疗近端舟骨骨不连,没有塌陷或明显畸形。
OBJECTIVE: To analyze the results of treatment of scaphoid nonunion with questionable viability of the proximal fragment, but without significant deformity or collapse, using a vascularized bone graft of 1,2 intercompartmental supraretinacular artery (1.2 ICSRA) and subsequent osteosynthesis.
METHODS: A retrospective study was performed on 10 male patients with a radiographic diagnosis of nonunion. Functionality, pain using Visual Analog Score (VAS), grip strength, patient satisfaction and reintroduction to working life, using QuickDASH and May specific wrist scales were assessed after the treatment. The integration of the graft was checked by radiography.
RESULTS: The mean follow-up was 31.4 months, and 90% of the questionnaires were satisfactory. The VAS decreased by 4.6 points and the flexor-extensor mobility gain was 5°. The total graft consolidation rate reached 40% in 5.5 months on average.
CONCLUSIONS: Several studies have demonstrated better results using vascularized bone graft versus non-vascularized. From the description by Zaidemberg in 1991, the vascularized graft with 1.2 ICSRA artery, distal radius, has been the most widely used for the treatment of scaphoid nonunion.
CONCLUSIONS: Our results are comparable with the literature reviewed, thus using vascular graft of the 1.2 ICSRA and osteosynthesis with Herbert-type screw, may be an alternative treatment for proximal scaphoid nonunion, without collapse or significant deformity.