摘要
目的：报道采用显微外科技术治疗腕月骨缺血性坏死２３例的临床效果。方法：３例采用带掌背血管蒂的骨瓣月骨植入术；２０例采用月骨切除和带血管蒂的豌豆骨移位替代月骨。结果：随访８～５１个月，平均３０个月。２２例腕痛缓解，腕关节活动改善，背伸达正常的５３．４％，屈曲达４４．２％，握力达正常侧的８０．９％。Ｘ线照片显示带掌背血管蒂骨瓣月骨内植入后月骨密度降低。带蒂豌豆骨转移位置正常，２例术后２年发现豌豆骨萎缩。腕高比值０．４９，ＭｃＭｕｒｔｒｙ指数０．２９．桡舟角平均５６．８。结论：应用带血管蒂豌豆骨移位替代月骨是治疗月骨缺血性坏死Ⅲ期的一种有效方法，月骨缺血性坏死Ⅱ期应采用月骨再血管化手术。
Objective:To report the curative result of kienbock's Disease treated by micro- surgical technique. Methods:3 cases in stage Ⅱ were treated by the pedicled bone flap with the dorsal metacarpal vessels inserting into the lunate,two cases in stage Ⅱ and 18 cases in stage Ⅲ were treated by lunate excision,and transfer of pedicled pisiform bone in place of lunate. Results:All patients were followed up for 8～51 months with an average of 30 months. Complete relief of pain was obtained in 22 cases。Ranges of motion of wrist were improved.Extension of wrist was averaged 53.4%of the normal side and flexion 44.2%。The grip strength was increased to 80.9%of the normal side。17 cases of the 23 pattents returned to their original jobs and 4 patients changed their jobs for social reason. Two pa- tients changed their job.ConclusiOu:We considered the transfer of pedicled pisiform bone in place of lunate following its excision an effective method to treat Kienbock's disease of stage Ⅲ.The procedure of lunate revasculaization should be used in stage Ⅲ of Kienbock's disease.
出处
《中华显微外科杂志》
CSCD
北大核心
1996年第2期102-104,共3页
Chinese Journal of Microsurgery
关键词
显微外科
腕骨
月骨
缺血坏死
Microsurgery Wrist bone Kienbock disease
