Effect of bone flap pedicled with the second communicating branch between dorsal wrist middle and distal arterial arch in treatment of scaphoid fracture nonunion
Objective To investigate the clinical effect of the bone flap pedicled with the second communicating branch be-tween dorsal wrist middle and distal arterial arch in the treatment of scaphoid fracture nonunion.Methods The clinical data of 32 pa-tients with nonunion scaphoid bone fracture admitted to the Third Hospital of Hebei Medical University and Hebei Provincial Corps Hos-pital of Chinese People's Armed Police Force from April 2015 to December 2021 were retrospectively analyzed.All patients were trea-ted with the dorsal base bone flap of the second metacarpal bone with blood supply,which was based on the second communicating branch between the middle and distal arterial arch of the dorsal wrist.The operative parameters of the patients were recorded,and the range of motion of the wrist joint after operation was measured by the goniometer and compared with the measured values recorded be-fore operation.The visual analogue Scale was used to assess wrist pain index and the Mayo wrist score was used to assess postoperative wrist function.Results All the 32 patients were successfully operated.The average size of bone flap was 11 mm×6 mm×5 mm and the average pedicle length was 16 mm.The bone healing time was 8-16 weeks(average 10 weeks).The average follow-up was 30 months(26-37 months).The mean navicular angle after operation was 13°(-4°-16°),which was significantly better than that before opera-tion 28°(21°-36°),and the difference was statistically significant(P<0.05).The mean radial angle of 10° was also significantly better than that of 17° before surgery,and the difference was statistically significant(P<0.05).Compared with the preoperative re-sults,the mean height of CT coronal surface and the Mayo score of wrist joint function were also significantly better after operation.Conclusions The use of the second metacarpal dorsal base bone flap pedicled with the second communicating branch between the dor-sal middle and distal arterial arches of the wrist is effective in the treatment of scaphoid fracture nonunion.
dorsal wrist middle and distal arterial archthe second communicating branchdorsal base of the second metacarpalscaphoidpedicle bone flap
国家科技期刊平台
NSTL
万方数据
