Sato Kazuki, Iwamoto Takuji, Matsumura Noboru, Suzuki Taku, Nishiwaki Yuji, Nakamura Toshiyasu
1 Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
2 Department of Environmental and Occupational Health, Toho University, Tokyo, Japan.
J Hand Surg Eur Vol. 2019 Feb;44(2):167-174. doi: 10.1177/1753193418806195. Epub 2018 Oct 22.
The purpose of this study was to evaluate the mid- to long-term clinical outcomes of total finger joint arthroplasty using a costal osteochondral autograft for joint ankylosis. Twenty-three joints (three metacarpophalangeal joints, 20 proximal interphalangeal joints) in 23 patients (19 men and four women) were treated with a costal osteochondral autograft and were evaluated after a mean follow-up of 77 months (60-138). Mean age was 33 years (18 to 55). Significant improvement in active finger extension/flexion was seen from a preoperative mean of -24°/26° (arc: 2°) to -13°/75° (arc: 63°) at latest follow-up. Mean preoperative Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder and Hand score was initially 24 and improved significantly to 5 at latest follow-up. Conclusion: total finger arthroplasty using a costal osteochondral autograft gave an anatomical and biological reconstruction and provided stable improvement at a mean follow-up of 77 months. Level of evidence: IV.
本研究的目的是评估采用肋软骨自体移植治疗关节强直的全手指关节置换术的中长期临床疗效。23例患者（19例男性，4例女性）的23个关节（3个掌指关节，20个近端指间关节）接受了肋软骨自体移植治疗，并在平均随访77个月（60 - 138个月）后进行评估。平均年龄为33岁（18至55岁）。在最近一次随访时，手指主动伸展/屈曲从术前平均-24°/26°（弧度：2°）显著改善至-13°/75°（弧度：63°）。术前日本手部外科学会版上肢、肩部和手部功能障碍评分平均为24分，在最近一次随访时显著改善至5分。结论：采用肋软骨自体移植进行全手指关节置换术实现了解剖学和生物学重建，并在平均77个月的随访中提供了稳定的改善。证据级别：IV。
