陈旧性腕舟骨骨折的治疗分析

目的 通过对腕舟骨骨不连三种治疗方法的临床观察与分析，探讨治疗腕舟骨骨不连接的有效手术方法。方法 从1988年－2001年，采用桡骨茎突切除加植骨术治疗腕舟骨骨折骨不连11例，桡骨茎突切除植骨加游离骨膜移植术5例，带血管筋膜蒂的第二掌骨骨瓣移位术6例。结果 术后22例获得随访，随访时间4个月－12年，骨性愈合率100％，愈合时间为3－4个月，腕关节功能完全恢复，无腕关节不稳、创伤性关节炎等并发症发生。结论 三种手术方法有各自的适应证：桡骨茎突切除加植骨适用于无坏死的陈旧舟骨骨折；桡骨茎突切除植骨加游离骨膜移植适用于舟骨断端植骨后有间隙，软骨缺损的舟骨骨折；带血管筋膜蒂的第二掌骨骨瓣适用于舟骨近端无菌坏死的舟骨骨折。

Analysis of the treatment to old fracture of scaphoid bone

Objective To search an effect method to treat Carpal Scaphoid Bone Nonunion (CSBN) ,according to clinical observation and analysis of three treating methods to CSBN . Methods 11 cases of CSBN were cured with Radius Processus Styloideus Resect Plus Bone Grafting (RPSRBG) , 5 cases were cured with Radius Processus Styloideus Resect plus Bone Grafting plus Free Periost Grafting (RPSRGFPG ) , 6 cases were cured with transposition of the second Metacarpal bone Flap with Vasculofacial Pedicle ( TSMFVP) .Results 22 cases were followed-up, bone healing rate is 100%. Carpal joint function recovered completely ,no carpal joint unsteadiness was found. Conclusion Three operative methods have their own indication. RPSR?BG is fit for old scaphoid bone fracture of sterile necrosis . RPSRBGFGP is fit for the scaphoid bone fracture that there is spatium and cartilage defection after fracture bone grafting . TSMFVP is fit for the scaphoid bone with sterile necrosis in proximal end .