应用桡动脉茎突返支为蒂的桡骨骨瓣或骨膜瓣移植治疗腕舟骨骨折不连接

目的观察以桡动脉返支为蒂的桡骨骨瓣或骨膜瓣移植对腕舟骨骨折不连接的治疗作用.方法20例腕舟骨骨折骨不连,应用桡动脉返支为蒂的桡骨骨瓣移植加桡骨茎突切除治疗12例,应用桡动脉返支为蒂的桡骨骨膜瓣移植加桡骨茎突切除治疗8例.测量手术前后腕关节屈伸和尺桡偏活动度、握力,应用腕舟评分对患者的自觉功能恢复情况进行评定.结果20例腕舟骨骨折骨不连均愈合,愈合时间平均为7±0.2周(6～12周).腕舟骨评分结果为:优16例,良3例,可1例.结论以桡动脉返支为蒂的桡骨骨瓣或骨膜瓣移植加桡骨茎突切除是治疗腕舟骨骨折骨不连的有效方法.

Grafting of Radial Periosteal Bone Flap or Periosteum Flap Pedicled on Styloid Process Recurrent Branch of Radial Artery for Treatment of Scaphoid Nonunion

Objective To observe the effect of vascularized radial bone or periosteum graft pedicled on the styloid process recurrent branch of radial artery for treatment of scaphoid nonunion. Methods Twenty patients with scaphoid nonunion were investigated. Twelve of 20 were treated by stylectomy plus vascularized radial periosteum graft and 8 by stylectomy plus vascularized radial bone graft pedicled on the stylus recurrent branch of radial artery. The motion range of the wrist (flexion, extension, ulnar deviation and radial deviation) and the grip strength were measured before and after operation. The outcome based on the patients'perception of function was evaluated by the scaphoid score. Results The scaphoid fracture was united in all the patients. The mean healing time was 7.2 weeks (range, 6 to 12 weeks). The range of motion and the grip strength after operation were significantly increased compared with those before operation. The outcome based on scaphoid score showed that the excellent result was achieved in 16 patients, good in 3, fair in one and poor in none. Conclusion The radial bone or periosteum flap graft pedicled on styloid process recurrent branch of radial artery combined with stylectomy are the effective methods for the treatment of scaphoid nonunion.