Odella Simona, Querenghi Amos M, Locatelli Francesco M, Dacatra Ugo, Creta Elia, Tos Pierluigi
Operative Unit of Microsurgery and Hand Surgery, Ospedale Gaetano Pini-CTO, Milan, Italy.
Joints. 2018 Feb 12;6(1):37-41. doi: 10.1055/s-0038-1626738. eCollection 2018 Mar.
The aim of this study was to evaluate the effectiveness and the safety of performing a four-bone arthrodesis (FBA) with dorsal locking plate in patients suffering from stage III scapholunate advanced collapse/scaphoid nonunion advance collapse (SLAC/SNAC) wrist. We evaluated retrospectively 20 patients surgically treated by a FBA with the use of locking dorsal plate. All the patients were clinically evaluated at follow-up for grip strength, range of motion, and pain (visual analog scale), and with the Disability of the Arm, Shoulder and Hand score and the Mayo wrist score. Imaging evaluation was performed on standard X-rays. The mean follow-up was 6 years (range: 1-11 years). During follow-up, the patients showed good clinical outcomes in terms of pain relief and grip strength. Revision surgery was necessary only in one case because of screws loosening. In all cases, a solid bone fusion was achieved except in one patient, who presented a healing of lunocapitate joint. This condition did not affect the clinical outcomes. FBA performed using a dorsal locking plate is a salvage procedure effective in treating stage III SLAC/SNAC wrist. In our study, this technique provided good clinical outcomes at mid-term follow-up with a very low complication rate. Level IV, therapeutic case series.
本研究的目的是评估在患有III期舟月骨高级塌陷/舟骨不愈合高级塌陷（SLAC/SNAC）腕关节的患者中使用背侧锁定钢板进行四骨融合术（FBA）的有效性和安全性。我们回顾性评估了20例接受使用锁定背侧钢板的FBA手术治疗的患者。所有患者在随访时均进行了临床评估，包括握力、活动范围和疼痛（视觉模拟评分），并采用手臂、肩部和手部功能障碍评分及梅奥腕关节评分。通过标准X线进行影像学评估。平均随访时间为6年（范围：1 - 11年）。在随访期间，患者在疼痛缓解和握力方面显示出良好的临床结果。仅1例因螺钉松动需要翻修手术。在所有病例中，除1例月头状关节愈合的患者外，均实现了牢固的骨融合。这种情况未影响临床结果。使用背侧锁定钢板进行的FBA是一种有效的挽救手术，可用于治疗III期SLAC/SNAC腕关节。在我们的研究中，该技术在中期随访时提供了良好的临床结果，并发症发生率非常低。IV级，治疗性病例系列。
