游离骨皮瓣救援腕骨骨折癒合不良.PDF

游離骨皮瓣救援腕骨骨折癒合不良 呂明川 李俊達 鄭立福 王健興 吳孟熹 邱智弘 黃介琦 簡守信 佛教花蓮 、大林、台中慈濟綜合醫院 整形外科 Free medial femoral condyle corticoperiosteal bone flap for salvage of nonunion scaphoid fracture 1 1 1 1 1 Ming-Chuan Lu , Jiunn-Tat Lee , Li-Fu Cheng , Chien-Hsing Wang , Meng-Si Wu , 1 2 2 Zhong-Qian Lin , Chieh-Chi Huang , Sou-Hsin Chien Division of Plastic Surgery, Department of Surgery, Tzi-Chi Genaral Hospital, Taiwan, 1 2 Hualien and Dalin Branch , Taiwan, R.O.C. Purpose: Wrist bone fracture was common in the hand trauma . Primary management of wrist fracture often were immobilization or open reduction. But complication as nonunion was found in some case. And the wound healing and functional recover always not well, with some symptoms left as painful sensation and limited movement. We shared our experience of vascularized bone graft for salvage of wrist bone nonunion. Materials and Methods: A case of 38-year-old male patient, he suffered from right wrist pain for 2 weeks. Previous medical record showed the history of scaphoid fracture with nonunion . We designed a free medial femoral condyle corticoperiosteal bone flap for temponade the bone defect combined with K-pin fixation. Donor site was primary closed without skin graft. Results: After several months (1 month, 3 months and 6 months) of follow up, image study showed the improvement of nonunion. Clinical symptoms as pain were also improved and increased movement. Donor site morbidity was almost neglected excepted one linear scar. The patient returned to normal daily activity smoothly. Conclusion: Wrist bone frac