Clinical Research Of Pronator Quadratus Muscle Flap Combined With Radial Autologous Red Bone Marrow Transplantation Assisted In Antler Zhuanggu Capsule In Treatment Of Scaphoid Nonunion

Objective We described the technique of treatment of pronator quadratus muscle flap combined with radial autologous red bone marrow transplantation assisted in Antler Zhuanggu capsule in treatment of scaphoid nonunion.Methods From january2008to january2011,24patiants with scaphoid nonunion were treated with pronator quadratus muscle flap combined with radial autologous red bone marrow transplantation,and Antler Zhuanggu capsule were given. Including17males and7females;10cases in the left side, and14cases in the right side; From17years to45years, the mean age was (25.4±6.4) years. The causes of injury:falls in12cases, car accident injuries in7cases, heavy crushing injury in5cases. All patients were followed up to understand the fracture healing, measuring wrist joint flexion and extension, and the MMWS scoring system were adopted for assessment of wrist function, and were compared with the contralateral wrist range of motion and wrist function. Results24patients were followed up for12to20months. The wound healing after surgery were in good condition, and after2to4months all the patients achieved the bone healing, the healing rate was100%. The average postoperative range of activities in the ipsilateral dorsiflexion, flexion, ulnar deviation, radial deviation range were still less than that in the contralateral and other wrist range of motion, the difference was statistically significan (P<0.05); but the values of average grip strength and pinch strength were not significantly different between them(P>0.05).24patients were underwent functional evaluation, the excellent in15cases, good in5cases, moderate in4cases, the rate of good was83.33%(20/24).19patients were without pain; five cases felt a moderate pain while doing forced activities. All patients were satisfied with the surgical results.Conclusion This method for treating scaphoid nonunion is a simple operation. The grafts has stable blood supplyment,and the fractures get unioned much quickly,The motion of wrist recover satisfactorily. And auxiliary applications of Antler Zhuanggu capsule can relieve pain, accelerate fracture machine of unobstructed blood to prevent the adhesion of the joint, and it is an effective method in the treatment of scaphoid nonunion.