Le Glédic B, Hidalgo Diaz J J, Vernet P, Gouzou S, Facca S, Liverneaux P
Icube CNRS 7357, CCOM, department of hand surgery, SOS main, university hospital of Strasbourg, FMTS, university of Strasbourg, 10, avenue Baumann, 67400 Illkirch, France.
Icube CNRS 7357, CCOM, department of hand surgery, SOS main, university hospital of Strasbourg, FMTS, university of Strasbourg, 10, avenue Baumann, 67400 Illkirch, France.
Hand Surg Rehabil. 2018 Apr;37(2):104-109. doi: 10.1016/j.hansur.2017.11.008. Epub 2018 Mar 2.
No study has compared the QuickDASH score after Swanson implant arthroplasty performed by dorsal versus volar approaches. This study compared the outcomes of PIP arthroplasties through a volar approach as described by Schneider versus a dorsal approach as described by Chamay by determining the QuickDASH score, pain and range of motion. Our series included 21 Swanson implant arthroplasty cases in 17 patients aged 62 years on average, among which 12 were females. A volar approach was performed in 9 cases (group I) and a dorsal approach was performed in 12 cases (group II). The difference between the average QuickDASH score preoperatively and at the last follow-up was strong (group I: -16.584; group II: -1.444), the difference between the average pain level preoperatively and at the last follow up was very strong (group I: -2.098; group II: -4.506), the difference in average PIP extension was not different from 0 (group: I -5.805; group II: -11.332), the difference in average PIP flexion was very strong (group I: -2.716; group II: -2.007). There were four recurrences of swan neck deformity (3 in group, 1 in group II) and one implant fracture in each group. For Swanson implant arthroplasty, the volar approach leads to better QuickDASH scores and PIP flexion compared to the dorsal approach. The volar approach did not improve PIP extension, or pain, and did not lead to dysesthesia.
尚无研究比较过经背侧入路与掌侧入路行Swanson植入式关节成形术后的QuickDASH评分。本研究通过测定QuickDASH评分、疼痛程度和活动范围，比较了采用Schneider描述的掌侧入路与Chamay描述的背侧入路行近端指间关节（PIP）成形术的效果。我们的研究系列包括17例患者的21例Swanson植入式关节成形术病例，患者平均年龄62岁，其中女性12例。9例行掌侧入路（I组），12例行背侧入路（II组）。术前与末次随访时平均QuickDASH评分的差异显著（I组：-16.584；II组：-1.444），术前与末次随访时平均疼痛水平的差异非常显著（I组：-2.098；II组：-4.506），平均PIP伸展度的差异与0无显著差异（I组：-5.805；II组：-11.332），平均PIP屈曲度的差异非常显著（I组：-2.716；II组：-2.007）。天鹅颈畸形复发4例（I组3例，II组1例），每组各有1例植入物骨折。对于Swanson植入式关节成形术，与背侧入路相比，掌侧入路可带来更好的QuickDASH评分和PIP屈曲度。掌侧入路并未改善PIP伸展度或疼痛程度，也未导致感觉异常。
