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1.湖北医药学院附属国药东风总医院急救医学部,湖北 十堰 442000
2.武汉大学中南医院骨外科,湖北 武汉 430062
3.湖北医药学院附属国药东风总医院信息统计中心,湖北 十堰 442000
方志辉,E-mail:25910033@qq.com
纸质出版日期:2024-12-25,
收稿日期:2023-03-06,
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雷鹏程,方志辉,陶圣祥等.桡动脉茎突返支蒂桡骨茎突骨(膜)瓣治疗腕舟状骨骨折的解剖基础与临床效果[J].局解手术学杂志,2024,33(12):1066-1069.
LEI Peng-cheng,FANG Zhi-hui,TAO Sheng-xiang,et al.Anatomical basis and clinical effect of radical styloid process bone (membrance) flap pedicled with the recurrent branch of radial artery to styloid process in the treatment of carpal scaphoid fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(12):1066-1069.
雷鹏程,方志辉,陶圣祥等.桡动脉茎突返支蒂桡骨茎突骨(膜)瓣治疗腕舟状骨骨折的解剖基础与临床效果[J].局解手术学杂志,2024,33(12):1066-1069. DOI: 10.11659/jjssx03E023024.
LEI Peng-cheng,FANG Zhi-hui,TAO Sheng-xiang,et al.Anatomical basis and clinical effect of radical styloid process bone (membrance) flap pedicled with the recurrent branch of radial artery to styloid process in the treatment of carpal scaphoid fracture[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(12):1066-1069. DOI: 10.11659/jjssx03E023024.
目的
2
探讨桡动脉茎突返支蒂桡骨茎突骨(膜)瓣修复腕舟状骨骨折的解剖学基础及临床效果。
方法
2
测量25例成人桡骨标本桡骨茎突的等位长度;解剖1具乳胶灌注男性成人上肢标本,观察桡动脉茎突返支的走行及分布。回顾性分析15例以桡动脉茎突返支为蒂行桡骨茎突骨(膜)瓣转位植入修复腕舟状骨骨折患者的临床资料,分析其治疗效果。
结果
2
25例桡骨标本测量结果显示,桡骨茎突长11~16 mm。解剖乳胶灌注男性成人上肢标本发现:在鼻烟窝内的桡动脉于茎突下方(1.2±0.2)cm处向尺侧发出1支较粗的腕背支,再向近端发出返回茎突部的分支。15例患者术后骨折线消失,骨折愈合率100%,平均愈合时间为12周;Krimmer腕关节功能评分显示,优6例,良7例,可2例,优良率为86.7%;患者术后疼痛视觉模拟量表评分低于术前,差异具有统计学意义(
P
<
0.05)。
结论
2
通过测量实物标本桡骨茎突,观察成人上肢标本桡动脉茎突返支的走行及分布情况,可以指导临床治疗腕舟状骨骨折手术方案的制定。桡动脉茎突返支蒂桡骨茎突骨(膜)瓣转位植入治疗腕舟状骨骨折可以有效促进骨折愈合,降低延迟愈合风险,术后腕关节功能恢复良好,临床效果确切。
Objective
2
To explore the anatomical basis and clinical effect of radical styloid process bone (membrance) flap pedicled with the recurrent branch of radial artery to styloid process for repairing carpal scaphoid fracture.
Methods
2
The equal lengths of the radial styloid process in 25 adult radial specimens were measured. A latex-perfused male adult upper limb specimen was dissected to observe the course and distribution of the recurrent branch of radial artery to styloid process. The clinical data of 15 patients with carpal scaphoid fracture repaired by transposition and implantation of radical styloid process bone (membrance) flap pedicled with the recurrent branch of radial artery to styloid process were retrospectively analyzed,and the therapeutic effect was analyzed.
Results
2
The length of the radial styloid process measured on 25 radial specimens was 11 to 16 mm.Dissection of the latex-perfused male adult upper limb specimens revealed:the radial artery in the snuffbox emitted a thicker dorsal carpal branch to the ulnar side at (1.2±0.2) cm below the styloid process, and then sent a branch proximally back to the styloid process. The fracture line of 15 patients disappeared after surgery, with a fracture healing rate of 100%, and a mean healing time of 12 weeks; the Krimmer wrist joint function score showed that 6 cases were excellent, 7 cases were good, and 2 cases were acceptable, with excellent and good rate of 86.7%; patients had lower postoperative pain visual analogue scale scores compared with those before surgery,the difference was significant (
P
<
0.05).
Conclusion
2
Measuring the radial styloid process of the physical specimen and observing the course and distribution of the recurrent branch of radial artery to styloid process in adult upper limb specimens can guide the formulation of surgical plan for the treatment of carpal scaphoid fractures in clinic.The transposition and implantation of radical styloid process bone (membrance) flap pedicled with the recurrent branch of radial artery to styloid process can effectively promote fracture healing, and reduce the risk of delayed healing, which has good postoperative recovery of wrist joint function and definite clinical effect in the treatment of carpal scaphoid fractures.
腕舟状骨骨折桡骨茎突骨瓣转位桡动脉茎突返支解剖
carpal scaphoidfracturetransposition of radial styloid process bone flaprecurrent branch of radial artery to styloid procesanatomy
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