Guidera P M, Watson H K, Dwyer T A, Orlando G, Zeppieri J, Yasuda M
Division of Hand Surgery, Good Samaritan Regional Medical Center, Phoenix, AZ, USA.
J Hand Surg Am. 2001 May;26(3):422-7. doi: 10.1053/jhsu.2001.24969.
Previous reports of lunotriquetral arthrodesis suggest relatively low rates of primary fusion without the use of permanent fixation and/or prolonged immobilization. We performed 26 lunotriquetral arthrodeses in 24 patients with a technique using cancellous bone graft to fill a biconcave space created in the adjoining bones with parallel K-wire fixation. The indications included symptomatic lunotriquetral instability and degenerative arthritis. All patients received conservative treatment before surgery. Primary fusion was achieved in all wrists in an average of 50 days. Postoperative wrist flexion/extension averaged 77%/80% of unaffected sides. Radial/ulnar deviation averaged 95%/91% of unaffected sides. Pain relief was good or very good in 83%. Eight-eight percent returned to the workforce. This study shows reliable, effective results with a technique that adheres to the principles of intercarpal arthrodesis and avoids permanent internal fixation.
既往有关月三角关节融合术的报道表明，在不使用永久固定和/或长期制动的情况下，一期融合率相对较低。我们采用松质骨移植技术，填充相邻骨骼间形成的双凹间隙，并使用平行克氏针固定，为24例患者实施了26次月三角关节融合术。适应证包括有症状的月三角关节不稳和退行性关节炎。所有患者在手术前均接受了保守治疗。所有腕关节均在平均50天内实现了一期融合。术后腕关节的屈伸活动平均为健侧的77%/80%。桡偏/尺偏平均为健侧的95%/91%。83%的患者疼痛缓解良好或非常好。88%的患者恢复了工作。本研究表明，该技术遵循腕骨间关节融合术的原则，避免了永久内固定，结果可靠且有效。
