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Injerto Óseo No Vascularizado para Pseudoartrosis Escafoidea
Viviana M Serra López1, Scott W Wolfe1
1Department of Hand and Upper Extremity Surgery, Hospital for Special Surgery, New York, New York.
Journal of wrist surgery
|January 23, 2026
Resumen
Los injertos óseos no vascularizados tratan eficazmente las pseudoartrosis escafoides, y el procedimiento híbrido de Russe muestra resultados prometedores. Esta técnica quirúrgica ayuda a restaurar la alineación carpiana y los defectos óseos para la curación de fracturas escafoides.
Área de la Ciencia:
- Cirugía ortopédica; Cirugía de mano; Traumatología
Sus antecedentes:
- Las pseudoartrosis escafoides requieren fijación estable, restauración de la alineación carpiana y reconstrucción del defecto óseo.; Los defectos óseos pueden manejarse con injertos óseos vascularizados o no vascularizados, según la preferencia del cirujano.
Objetivo del estudio:
- Describir el uso de injertos óseos no vascularizados para pseudoartrosis escafoides.; Examinar los resultados reportados de injertos óseos no vascularizados.; Detallar el procedimiento híbrido de Russe para el manejo de la pseudoartrosis escafoides.
Principales métodos:
- El procedimiento híbrido de Russe utiliza un injerto corticomedular de radio distal volar.; Restaura la alineación del escafoides y el semilunar.; La fijación se completa con un tornillo de compresión sin cabeza.
Principales resultados:
- El procedimiento híbrido de Russe logró la curación en 17 pseudoartrosis de fractura escafoides.; El tiempo promedio de curación fue de 15 semanas.; No se observan diferencias significativas en las tasas de unión entre los tipos de injerto en la literatura.
Conclusiones:
- Los injertos óseos no vascularizados son una opción viable para las pseudoartrosis escafoides.; El procedimiento híbrido de Russe trata eficazmente las pseudoartrosis escafoides con deformidades en flexión.; La discreción del cirujano guía la elección del injerto cuando el polo proximal del escafoides es salvable.
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