Gaulke R, Suppelna G, Hildebrand F, Citak M, Hüfner T, Krettek C
Unfallchirurgische Klinik, Medizinische Hochschule Hannover and Orthopädische Klinik II: Rheumaorthopädie Handchirurgie und Endoprothetik, Evangelische Stiftung Volmarstein, Germany.
J Hand Surg Eur Vol. 2010 May;35(4):289-95. doi: 10.1177/1753193409342054. Epub 2009 Aug 17.
We performed a retrospective clinical and radiological case control study on 22 rheumatoid wrists following radiolunate fusion via Shapiro staples with a mean follow-up of 5 years. Radiographs showed one early loosening through dorsal staple migration and four nonunions. Six wrists fused in mild ulnopalmar dislocation of the lunate. Primary intra-articular positioning of a staple was found in nine wrists, secondary intra-articular staple dislocation was found in two wrists. Dorsal staple dislocation was found in four fused arthrodeses. Osteolysis around the staples was found in all but two wrists. In contrast to unsatisfactory radiological results the clinical results were good or excellent in 18 patients. Good and excellent clinical results in the majority of the patients following radiolunate fusion does not depend on the fixation device. Nevertheless staple fixation of the radiolunate joint in the rheumatoid wrist is associated with a high rate of radiological complications.
我们对22例采用夏皮罗钉进行桡月关节融合的类风湿性腕关节进行了一项回顾性临床和放射学病例对照研究，平均随访5年。X线片显示1例因背侧钉移位导致早期松动，4例不愈合。6例腕关节在月骨轻度尺掌侧脱位时融合。9例腕关节发现钉的初始关节内定位，2例腕关节发现继发性关节内钉脱位。4例融合关节固定术发现背侧钉脱位。除2例腕关节外，其余所有腕关节均发现钉周围骨质溶解。与不满意的放射学结果相反，18例患者的临床结果良好或优秀。大多数类风湿性腕关节桡月关节融合术后患者的良好和优秀临床结果并不取决于固定装置。然而，类风湿性腕关节桡月关节的钉固定与较高的放射学并发症发生率相关。
