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目的 评价镍钛记忆合金舟大小融合器(NiTi shape memory alloy STT arthrodesis concentrator,NT-STAC)治疗月骨无菌性坏死的临床效果.方法 对16例Lichtman分期Ⅲb期的月骨无菌性坏死患者,使用镍钛记忆合金舟大小融合器行舟骨及大小多角骨局限性腕骨融合术(scapho-trapezio-trapezoeid arthrodesis,STT融合术),术后平均随访12个月,随访内容包括术后患手握力、腕关节活动范围、腕关节疼痛程度、腕关节X线片腕高比.采用疼痛视觉模拟评分(visual analogue scales,VAS)评估腕关节疼痛程度.采用Mayo腕关节评分表对腕关节总体功能进行评价.结果 术前患侧平均握力(21.60±6.00) kg、健侧平均握力(32.65±5.28)kg,术后患侧平均握力为(28.30±5.20)kg、健侧平均握力(31.95±4.19)kg,恢复至健侧的88.5％;术后腕关节活动范围较术前掌屈好转,背伸明显好转.X线检查未见骨不连病例,坏死塌陷的月骨有不同程度的恢复.无伤口感染病例.VAS评分腕关节疼痛值休息状态下:术前为(4.57±1.16)分,术后为(1.23±0.85)分;负重状态下:术前为(7.12±1.39)分,术后为(2.53±1.11)分,差异有统计学意义(P＜0.05).Mayo腕关节评分值为79分,术后优良率为87.5％.结论 应用镍钛记忆合金舟大小融合器(NT-STTAC)进行舟大小融合术能保留大部分腕关节功能,是治疗月骨无菌性坏死的可靠、有效的办法.“,”Objective To evaluate the results of NiTi shape memory alloy STT arthrodesis concentrator (NT-STTAC) for rotatory subluxation of the scaphoid and Kienbock diseases.Methods Seven patients with rotatory subluxation of the scaphoid and 4 Kienbock diseases patients were treated with STT arthrodesis by NTSTTAC.The mean follow-up time was 12 months after operation.The grip strength,the range of the wrist and radiograph were recorded for all patients.Wrist pain was self-assessed by visual analogous scales.The results were evaluated according to the Mayo wrist score system.Results Average grip strength of (28.30 ± 5.20) kg (88.5 ％ of opposite side) was achieved postoperatively.The mean range of the wrist reached over 53％ of the healthy side.Non-union or wound infection was not found.Preoperatively and 6 months postoperatively,mean pain was scored (4.57± 1.16) and (1.23±0.85) (non-weighted) (P＜0.05); (7.12± 1.39) and (2.53± 1.11) (weighted)(P ＜ 0.05).The mean value of Mayo wrist score was 79 with the excellent and good rate of 87.5％.Conclusion STT arthrodesis by NT-STTAC is an effective method to treat rotatory subluxation of the scaphoid and Kienbock diseases,and to preserve the majority function of wrist at the same time.