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[腕关节融合术。技术与结果]

[Wrist joint arthrodesis. Technique and outcome].

作者信息

Martini A K

机构信息

Sektion Hand- und Mikrochirurgie, Orthopädische Universitätsklinik Heidelberg-Schlierbach.

出版信息

Orthopade. 1999 Oct;28(10):907-12. doi: 10.1007/PL00003567.

Abstract

Arthrodesis of the wrist joint is indicated in degenerative joint desease, instability and restricted and painful range of motion. Further indications are: failed reconstruction, partial arthrodesis or arthroplasty/total joint replacement. The surgical technique depends mainly on the quality of bone substance and degree of joint degeneration. Differences can be made concerning the type of bone graft and osteosynthesis being used. The aim is to create, a stable joint in a good functional position. The position of arthrodesis depends on the patients needs. In patients with rheumatoid arthritis a straight position is generally accepted, where as in patients with degenerative joint desease, a slight wrist extension and ulnar deviation is preferred. A stable osteosynthesis with plates is reliable and allows early rehabilitation. We present 28 cases of arthrodesis with intramedullary rods and 61 cases of arthrodesis with plates. The complication rate was low, the functional results were good. We saw significant reduction of pain, increase of strength and handfunction. Arthrodesis of the wrist joint has proven to be a long term reliable and safe procedure. Loss of motion is accepted to obtain sufficient pain relief.

摘要

腕关节融合术适用于退行性关节疾病、关节不稳定以及活动范围受限且疼痛的情况。其他适应症包括:重建失败、部分关节融合术或关节成形术/全关节置换术。手术技术主要取决于骨质质量和关节退变程度。在使用的骨移植类型和骨固定方式方面存在差异。目的是在良好的功能位置创建一个稳定的关节。关节融合的位置取决于患者的需求。在类风湿性关节炎患者中,通常采用伸直位,而在退行性关节疾病患者中,轻微的腕关节伸展和尺侧偏斜更为可取。使用钢板进行稳定的骨固定是可靠的,并且允许早期康复。我们展示了28例使用髓内棒的关节融合术病例和61例使用钢板的关节融合术病例。并发症发生率低,功能结果良好。我们观察到疼痛明显减轻,力量和手部功能增强。腕关节融合术已被证明是一种长期可靠且安全的手术。为了获得足够的疼痛缓解,活动度的丧失是可以接受的。

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