UNASSIGNED:由于碎片大小和有限的血液供应,无法修复的舟骨近端极难以治疗。打捞手术,如部分腕关节融合术或近排腕关节切除术,可以进行,但不适合年轻患者。使用肋骨骨软骨移植物重建舟骨近端的报道很少。
UNASSIGNED:4例患者接受肋骨骨软骨移植重建舟骨近端极。患者术后平均随访24个月。手术时的平均年龄为30岁。结果测量包括手腕运动弧的总活动范围,握力,和手腕功能评分。我们还评估了骨关节炎的进展和腕骨高度的变化。
未经证实:供体部位未发生并发症。手术前后的运动范围从82°提高到95°。手术前后,握力从22kg提高到33kg。手术前后,Green和O\'Brien的腕关节功能评分从40分显着提高到70分。在所有患者的X光片上均未发现关节病的进展。手术前后腕高比无明显差别。
UNASSIGNED:舟骨近端骨折可能需要重建桡骨关节面,Capetate,和月球。肋骨骨软骨移植物的重建是灵活的,易于制造,可以重建三个关节面。
UNASSIGNED: An irreparable scaphoid proximal pole is challenging to treat because of the fragment size and limited blood supply. Salvage surgery, such as partial wrist fusion or proximal row carpectomy, may be performed but is not ideal for young patients. There are few reports of proximal scaphoid reconstruction using rib osteochondral grafts.
UNASSIGNED: Four patients were treated with rib osteochondral graft for reconstruction of the scaphoid proximal pole. The patients had a mean postoperative follow-up of 24 months. The mean age at the time of surgery was 30 years. Outcome measurements included total active range of wrist motion arc, grip strength, and wrist function score. We also evaluated the progression of osteoarthritis and changes in carpal height.
UNASSIGNED: No complications occurred at the donor site. The range of motion improved from 82° to 95° before and after surgery. Grip strength improved from 22 kg to 33 kg before and after surgery. There was a remarkable improvement in the modified wrist function scores of Green and O\'Brien from 40 points to 70 points before and after surgery. No progression of arthrosis was seen on the radiographs of all the patients. There was no significant difference in the carpal height ratio before and after surgery.
UNASSIGNED: Proximal scaphoid fractures may require reconstruction of the articular surfaces of the radius, capitate, and lunate. Reconstruction with a rib osteochondral graft is flexible, easy to fabricate, and can reconstruct the three articular surfaces.