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舟头状骨腕间关节融合术

Scaphocapitate intercarpal arthrodesis.

作者信息

Pisano S M, Peimer C A, Wheeler D R, Sherwin F

机构信息

Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York.

出版信息

J Hand Surg Am. 1991 Mar;16(2):328-33. doi: 10.1016/s0363-5023(10)80121-2.

Abstract

We reexamined 17 patients at 16 to 57 months (average, 23.4 months) after scaphocapitate arthrodesis. Surgery was performed for treatment of rotary scaphoid instability, isolated arthrosis, resistant scaphoid nonunion, and prevention of carpal collapse in Kienböck's disease. Scaphocapitate fusion with autogenous bone grafting was used to bridge carpal spaces. Two patients had nonunion of the scaphocapitate arthrodesis, which required reoperation. Seven patients experience persistent pain with heavy use; of these, two changed occupations and one remains disabled. Compared with the nonoperated side, scaphocapitate fusion reduced wrist extension an average of 28 degrees, flexion 40 degrees, radial deviation 14 degrees, and ulnar deviation 14 degrees. The greatest loss was of radial deviation. Static grip reached a average of 74% of the nonoperated side. Dynamic power regained 73%, and dynamic endurance measured 105% of the nonoperated side. Motion peaked after six months on average, and then reached a plateau. Static strength peaked at 11 months and then stabilized.

摘要

我们在舟头关节融合术后16至57个月(平均23.4个月)对17例患者进行了复查。手术用于治疗旋转性舟骨不稳定、孤立性关节病、难治性舟骨不愈合以及预防月骨无菌性坏死导致的腕骨塌陷。采用自体骨移植进行舟头融合以桥接腕骨间隙。2例患者舟头关节融合未愈合,需要再次手术。7例患者在重度使用时仍持续疼痛;其中,2例更换了职业,1例仍有残疾。与未手术侧相比,舟头融合使腕关节背伸平均减少28度,掌屈减少40度,桡偏减少14度,尺偏减少14度。桡偏的损失最大。静态握力平均达到未手术侧的74%。动力恢复到73%,动态耐力为未手术侧的105%。运动平均在6个月后达到峰值,然后趋于平稳。静态力量在11个月时达到峰值,然后稳定下来。

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