De Almeida Y K, Athlani L, Dap F, Dautel G
Department of hand surgery, plastic and reconstructive surgery. centre chirurgical Emile-Gallé, CHU de Nancy, 49, rue Hermite, 54000 Nancy, France.
Department of hand surgery, plastic and reconstructive surgery. centre chirurgical Emile-Gallé, CHU de Nancy, 49, rue Hermite, 54000 Nancy, France.
Hand Surg Rehabil. 2019 Jun;38(3):186-190. doi: 10.1016/j.hansur.2019.01.001. Epub 2019 Jan 23.
We report the clinical and radiographic results of distal interphalangeal (DIP) joint arthrodesis using the X-Fuse implant with a mean follow-up of 24 months (6-54). Forty-one patients (33 women and 8 men) with a mean age of 65 years were operated on. DIP joint arthrodesis was performed on 54 fingers for advanced osteoarthritis resistant to medical treatment. Pain evaluated on a visual analog scale (/10) was reduced significantly, going from 5 to 0.47. Functional DASH and PRWE-Hand Scores (/100) were improved by 33 and 36 points, respectively. Four fingers (7.4%) were sensitive to cold. No cases of nail dystrophy were reported. The fusion rate was 89%. Of the six patients (11%) who suffered a non-union, there was one case of asymptomatic fracture of the implant, without reoperation, and one case of infection, which required revision surgery. The fusion position was stable at the review visit. The repeat surgery rate was 3.7%; both cases were for infection. In light of this study, the X-Fuse implant is a viable alternative to traditional arthrodesis techniques (compression screws and pins), with a similar fusion rate. This implant appears to be very well tolerated by patients, with an absence of nail dystrophy and a reduction in the risk of infection.
我们报告了使用X-Fuse植入物进行远侧指间关节（DIP）融合术的临床和影像学结果，平均随访时间为24个月（6 - 54个月）。对41例患者（33名女性和8名男性）进行了手术，患者平均年龄为65岁。因晚期骨关节炎药物治疗无效，对54根手指进行了DIP关节融合术。采用视觉模拟评分法（/10）评估的疼痛显著减轻，从5分降至0.47分。功能DASH和PRWE-Hand评分（/100）分别提高了33分和36分。4根手指（7.4%）对冷敏感。未报告甲营养不良病例。融合率为89%。在6例（11%）发生不愈合 的患者中，有1例植入物无症状性骨折，未再次手术，1例感染，需要翻修手术。在复查时融合位置稳定。再次手术率为3.7%；两例均为感染。根据本研究，X-Fuse植入物是传统融合术技术（加压螺钉和克氏针）的可行替代方案，融合率相似。这种植入物似乎很受患者耐受，没有甲营养不良，感染风险降低。
