Richards Allison Alexander, Afifi Ahmed M, Moneim Moheb S
Department of Orthopaedics and Rehabilitation, Division of Hand Surgery, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA.
Tech Hand Up Extrem Surg. 2011 Jun;15(2):99-103. doi: 10.1097/BTH.0b013e3181f60fec.
Scapholunate advanced collapse and scaphoid nonunion advanced collapse wrist deformities are the most common causes of traumatic arthritis of the wrist. Four-corner fusion and scaphoid excision has proven to be an effective procedure for relieving pain and preserving range of motion in the wrist joint. Several methods for providing fixation of the midcarpal joint during fusion have been used, including K-wires, staples, and the Spider plate. K-wire fixation has proven effective, but requires a period of cast immobilization to protect the fusion mass. The Spider plate was promising, but has not been without complications. The development and improvements in cannulated headless compression screws has resulted in increased indications for their use, including fixation for 4-corner fusion. We review the technique and tips developed by the senior author over the last several years using headless compression screws for fixation of the midcarpal joint. Acutrak 2 Standard implants were used. This technique has allowed for early range of motion with reliable fusion rates.
舟月骨高级塌陷和舟骨不愈合高级塌陷性腕关节畸形是创伤性腕关节炎最常见的病因。四角融合术和舟骨切除术已被证明是缓解疼痛和保留腕关节活动范围的有效手术。融合过程中用于固定腕中关节的方法有多种，包括克氏针、钉和Spider钢板。克氏针固定已被证明有效，但需要一段时间的石膏固定以保护融合块。Spider钢板曾很有前景，但也并非没有并发症。中空无头加压螺钉的发展和改进导致其使用指征增加，包括用于四角融合的固定。我们回顾了资深作者在过去几年中使用无头加压螺钉固定腕中关节所开发的技术和技巧。使用了Acutrak 2标准植入物。该技术允许早期活动且融合率可靠。
