不同筋膜血管蒂骨瓣植入治疗舟状骨陈旧性骨折

目的介绍利用不同筋膜血管蒂桡骨茎突骨瓣植入治疗陈旧性腕舟状骨骨折的疗效。方法2002年9月-2010年5月，采用以桡动脉返支为蒂的骨瓣，或以骨间背动脉桡侧终末支的筋膜蒂骨瓣植入结合内固定治疗腕舟状骨陈旧性骨折41例。结果38例经6～27个月（平均19．3个月）的随访，X线片显示腕舟骨骨折均在术后4～6个月获得骨性愈合，愈合率达100％。腕关节活动度为4例腕掌屈60°背伸50°34例腕掌屈达70°-80°．背伸45°-55°。腕关节活动时无疼痛。腕关节功能按Krimmer评分表测定：总体疗效为优29例，良9例。结论采用带不同血管蒂桡骨茎突骨瓣植入治疗舟状骨陈旧性骨折疗效确切。

Treatment of chronic wrist scaphoid fracture with radial styloid bone flap graft

Objective To evaluate the curative effect of implanting radial styloid bone flap of different tor treating chronic wrist scaphoid fracture. Methods From September 2002 to May 2010, we had treated 41 patients who were chronic wrist scaphoid fracture by implanting recurrent branch of radial artery pedicled bone flap or the radial side terminal branch of the fascia pedicle bone flap combined with internal fixation for treatment. Results 38 patients were followed up for 6-27 months （an average of 19.3 months）. X-ray displayed that the wrist scaphoids were all bone healing at 4 to 6 months after operation, and the healing rate was 100%. The motion of wrist joint reached 60° of palmar flexion and 50° of back extend in 4 patients. 34 patients had 70°-80° of palmar flexion and 45°-55° of back extend. There was no pain when moving wrist. Wrist function was evaluated with Kximmer graded table and the overall effect was excellent in 29 cases, good in 9 cases. Conclusion It is accurate effect that implanting radial styloid bone flap of different vascular pedicle for treating chronic wrist scaphoid fracture.