Goubier Jean-Noël, Teboul Frédéric
Centre International de Chirurgie de la Main (CICM), clinique du parc Monceau, 21 rue de Chazelles, Paris, France.
Tech Hand Up Extrem Surg. 2007 Mar;11(1):24-8. doi: 10.1097/bth.0b013e31802caa87.
Scapholunate dissociation or scaphoid pseudarthrosis may lead to wrist osteoarthritis. When osteoarthritis concerns the midcarpal joint, proximal row carpectomy is not possible. Only 4-corner or capitolunate arthrodesis may be indicated. In this procedure, pseudarthrosis was frequently described in literature. However, in these series, fixation was performed with pins or staples. Type and position of the device are important to obtain carpal bones fusion. The efficiency of compression screws has been validated in scaphoid fracture or pseudarthrosis. Moreover, the axial position of the screws, parallel to the physiological wrist loads, may participate to improve bone fusion. Therefore, we present our technique of capitolunate arthrodesis with compression screws fixation through a dorsal approach.
舟月关节分离或舟状骨假关节可能导致腕关节骨关节炎。当骨关节炎累及腕中关节时,近端排腕骨切除术无法进行。仅可考虑进行四角融合术或头月关节融合术。在该手术中,假关节在文献中经常被描述。然而,在这些系列研究中,固定是用钢针或U形钉进行的。固定装置的类型和位置对于实现腕骨融合很重要。加压螺钉在舟状骨骨折或假关节中的有效性已得到验证。此外,螺钉的轴向位置与腕关节的生理负荷平行,可能有助于改善骨融合。因此,我们介绍通过背侧入路使用加压螺钉固定进行头月关节融合术的技术。