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[腕关节融合术:近端腕骨切除术的替代方案?]

[Wrist arthrodesis: alternative to resection of the proximal carpal bones?].

作者信息

Dap F

机构信息

Service de Chirurgie Plastique et Reconstructrice de l'appareil locomoteur, Hôpital Jeanne d'Arc, Dommartin-les-Toul.

出版信息

Ann Chir Main Memb Super. 1992;11(4):285-91. doi: 10.1016/s0753-9053(05)80473-9.

Abstract

The results of a series of 36 post-traumatic radio-carpal arthrodeses were compared with those of the series of resection of the first row of carpal bones reported during the round table. The advantages and disadvantages of both procedures were discussed. Arthrodesis results in: 1) loss of grip strength in all cases, averaging 41%; 2) persistent pain in 78% of cases; 3) impairment of function resulting from blocking of the wrist. After the procedure, average time off work is 15 months, level of permanent disability was 30%, and 20% of patients returned to their previous jobs. These figures could be used as arguments against arthrodesis. However, they must be taken in context: final arthrodesis, usually performed on manual workers, is often chosen when resection of the first row of carpal bones would obviously be insufficient, for example, when severe arthritis of the head of the capitate is present.

摘要

将36例创伤后桡腕关节融合术的结果与圆桌会议期间报告的一系列腕骨第一排切除术的结果进行了比较。讨论了两种手术方法的优缺点。关节融合术导致:1)所有病例握力丧失,平均丧失41%;2)78%的病例持续疼痛;3)因手腕固定导致功能受损。手术后,平均休假时间为15个月,永久残疾程度为30%,20%的患者恢复了原工作。这些数据可作为反对关节融合术的论据。然而,必须结合具体情况来看待这些数据:最终的关节融合术通常针对体力劳动者,当腕骨第一排切除术明显不足时,例如在存在严重头状骨头关节炎的情况下,通常会选择关节融合术。

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