Nydick Jason A, Watt James F, Garcia Michael J, Williams Bailee D, Hess Alfred V
Foundation for Orthopaedic Research and Education, Tampa, FL, USA.
J Hand Surg Am. 2013 May;38(5):899-903. doi: 10.1016/j.jhsa.2013.02.013. Epub 2013 Apr 3.
To compare clinical outcomes of wrist arthrodesis and total wrist arthroplasty in the treatment of pancarpal posttraumatic arthritis. We hypothesized that arthroplasty would demonstrate better clinical outcomes than wrist arthrodesis.
We performed a retrospective review of 22 patients treated (15 arthrodeses and 7 arthroplasties) for pancarpal posttraumatic arthritis. We measured clinical outcomes with the visual analog pain scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; the Patient-Rated Wrist Evaluation; and a study-specific questionnaire. Postoperative complications were recorded from chart review.
Mean follow-up was 68 months for arthrodesis and 56 months for arthroplasty. The mean visual analog scale pain score was 2 for each group. The mean Disabilities of the Arm, Shoulder, and Hand score was 38 for the arthrodesis group and 29 for the arthroplasty group. The mean Patient-Rated Wrist Evaluation was 73 for the arthrodesis group and 31 for the arthroplasty group. The results from the study-specific questionnaire revealed that the majority of patients in both groups were satisfied. Complication rates were similar in both groups.
Total wrist arthroplasty as an alternative to arthrodesis for the treatment of pancarpal posttraumatic arthritis may offer improved functional outcomes.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
比较腕关节融合术和全腕关节置换术治疗全腕创伤后关节炎的临床疗效。我们假设关节置换术的临床疗效优于腕关节融合术。
我们对22例接受全腕创伤后关节炎治疗的患者进行了回顾性研究（15例行关节融合术，7例行关节置换术）。我们使用视觉模拟疼痛量表、手臂、肩部和手部功能障碍问卷、患者自评腕关节评估以及一项特定研究问卷来测量临床疗效。通过病历审查记录术后并发症。
关节融合术的平均随访时间为68个月，关节置换术为56个月。每组的平均视觉模拟量表疼痛评分为2分。关节融合术组的平均手臂、肩部和手部功能障碍评分为38分，关节置换术组为29分。关节融合术组的平均患者自评腕关节评分为73分，关节置换术组为31分。特定研究问卷的结果显示，两组中的大多数患者都感到满意。两组的并发症发生率相似。
全腕关节置换术作为治疗全腕创伤后关节炎的关节融合术替代方案，可能会带来更好的功能结局。
研究类型/证据水平：治疗性III级。
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