Low A K, Edmunds I A
Hornsby Hand Centre, 2/49 Palmerston Road, Hornsby, NSW 2077, Australia.
Hand Surg. 2007;12(2):73-7. doi: 10.1142/S0218810407003523.
The scaphotrapeziotrapezoid (STT) joint is the second most common site in the wrist affected by degenerative arthritis. STT fusion has been the traditional treatment for patients with isolated STT arthritis but there are concerns about the complication rate and loss of wrist movement post-surgery. The current study presents the results of an interposition arthroplasty using a scaphoid trapezium pyrocarbon implant (STPI, BIOProfile). Ten STPI's were implanted in nine patients (mean age 66, 58-76 years) with isolated STT arthritis. The mean follow-up was 16.4 (3-35) months. Following surgery, VAS pain scores improved significantly and most patients had minimal restrictions in function, with a mean DASH score of 21. The mean wrist flexion-extension arc was 126 degrees and radioulnar deviation was 43 degrees. Mean grip strength was 82% and pinch strength 85% compared to the non-operated side. Patients were highly satisfied with the results of their surgery (mean VAS score 9.1). No surgical complications were encountered and no significant changes in carpal alignment were noted on radiographs. The results of this study suggest that STPI interposition arthroplasty may be a good alternative to STT fusion for isolated STT arthritis.
舟大多角小多角(STT)关节是腕关节中第二常见的受退行性关节炎影响的部位。STT融合术一直是孤立性STT关节炎患者的传统治疗方法,但人们对术后并发症发生率和腕关节活动度丧失存在担忧。本研究展示了使用舟大多角焦碳酸植入物(STPI,BIOProfile)进行间置关节成形术的结果。在9例(平均年龄66岁,58 - 76岁)孤立性STT关节炎患者中植入了10枚STPI。平均随访时间为16.4(3 - 35)个月。术后,视觉模拟评分(VAS)疼痛评分显著改善,大多数患者功能受限极小,平均 Disabilities of the Arm, Shoulder and Hand(DASH)评分为21分。平均腕关节屈伸弧度为126度,桡尺偏斜为43度。与未手术侧相比,平均握力为82%,捏力为85%。患者对手术结果高度满意(平均VAS评分为9.1)。未发生手术并发症且X线片上未发现腕骨排列有明显变化。本研究结果表明,对于孤立性STT关节炎,STPI间置关节成形术可能是STT融合术的良好替代方案。