Elgammal Ahmed, Deglmann Claus J, Celigoj Vanja, Lukas Bernhard
Department of Hand, Elbow and Plastic Surgery, Schön Klinik München Harlaching, Muenchen, Germany.
Department of Orthopedics, Ain Shams University Hospitals, Al Waili, Cairo Governorate, Egypt.
J Wrist Surg. 2018 Jul;7(3):262-266. doi: 10.1055/s-0037-1607072. Epub 2017 Oct 16.
The purpose of this prospective study was to evaluate the results of four-corner fusion using dorsal circular plate. We operated on 20 patients between 2009 and 2011. At a mean follow-up period of 30 months (range: 14-62, SD: 16), the mean VAS improved from 8 (range: 4-10, SD: 2) preoperatively to 4 (range: 0-8, SD: 2). Function measured with the DASH score improved from 37 (range: 10-75, SD: 18) to 26 (range: 2.5-64, SD: 19). Eighteen patients in our series showed full consolidation and two patients showed persistent nonunion. Three cases required plate removal due to dorsal impingement. Four-corner fusion using dorsal circular plate showed satisfactory results in this study, but it did not show superior results compared with simpler fixation methods mentioned in the literature, such as K-wires or screw fixation. Currently, we are principally using K-wires as a fixation method of choice in our four-corner fusion procedures. Level II.
本前瞻性研究的目的是评估使用背侧圆形钢板进行四角融合术的结果。2009年至2011年期间，我们对20例患者进行了手术。平均随访期为30个月（范围：14 - 62个月，标准差：16），视觉模拟评分（VAS）均值从术前的8分（范围：4 - 10分，标准差：2）改善至4分（范围：0 - 8分，标准差：2）。用上肢功能障碍评分（DASH）衡量的功能从37分（范围：10 - 75分，标准差：18）改善至26分（范围：2.5 - 64分，标准差：19）。我们系列中的18例患者显示完全融合，2例患者显示持续不愈合。3例因背侧撞击需要取出钢板。在本研究中，使用背侧圆形钢板进行四角融合术显示出令人满意的结果，但与文献中提到的更简单的固定方法（如克氏针或螺钉固定）相比，并未显示出更优的结果。目前，在我们的四角融合手术中，我们主要选择使用克氏针作为固定方法。二级。
