Gellman H, Rankin G, Brumfield R, Chandler D, Williams B
University of Southern California, Department of Orthopaedic Surgery, Rancho Los Amigos Medical Center, Downey 90240.
J Bone Joint Surg Am. 1989 Feb;71(2):223-7.
Sixty-three palmar-shelf arthroplasties (so-called pseudofusions of the wrist) that had been performed between 1970 and 1978 in forty-nine patients were evaluated. The length of follow-up averaged eighty-three months (minimum, twelve months for the wrists that fused and twenty-four months for those that did not). Preoperatively, all wrists were painful, with 96 per cent being moderately or severely so. Carpal subluxation was present in 79 per cent of the wrists. Postoperatively, pain recurred in 84 per cent of the wrists, but it was less severe (mild in 48 per cent, moderate in 35 per cent, and severe in 2 per cent). Sixty-eight per cent of the wrists fused spontaneously and were no longer painful. Of the twenty wrists (32 per cent) that did not fuse, 70 per cent were mildly or moderately painful. In patients who have rheumatoid arthritis, we found that palmar shelf arthroplasty was followed by a high rate of delayed spontaneous fusion and an unacceptably high rate of recurrent pain, although the pain was less severe.
对1970年至1978年间为49例患者实施的63例掌侧骨板成形术（即所谓的腕关节假性融合术）进行了评估。随访时间平均为83个月（融合的腕关节最短随访12个月，未融合的腕关节最短随访24个月）。术前，所有腕关节均有疼痛，其中96%为中度或重度疼痛。79%的腕关节存在腕骨半脱位。术后，84%的腕关节疼痛复发，但程度较轻（48%为轻度，35%为中度，2%为重度）。68%的腕关节自发融合，不再疼痛。在未融合的20例腕关节（32%）中，70%有轻度或中度疼痛。我们发现，对于类风湿性关节炎患者，掌侧骨板成形术后延迟自发融合率较高，疼痛复发率高得令人难以接受，尽管疼痛程度较轻。
