Nazerani Shahram, Nazerani Tina, Molayem Alireza, Keramati Mohammad Reza
Department of Surgery, Mehr General Hospital, Tehran, Iran.
Faculty of Medicine, Karl Josef Medical University, Graz, Austria.
J Wrist Surg. 2019 Feb;8(1):84-88. doi: 10.1055/s-0038-1669918. Epub 2018 Sep 18.
Arthroscopic total wrist arthrodesis is a procedure with minimal violation of extensor compartments and less scar formation, compared with open wrist arthrodesis. In this paper, we would like to present our experience with a modified surgical technique for arthroscopic total wrist arthrodesis. After an arthroscopic cartilage removal through radiocarpal and midcarpal portals, the operation is continued under fluoroscopic control. In this technique, four wires are inserted separately in four various directions (as described in the paper), followed by insertion of self-tapping cannulated screw, under fluoroscopic control. In this prospective study, a total of four patients underwent arthroscopic total wrist arthrodesis using our surgical technique within a period of 2 years. All four patients were followed for a minimum of 3 months for possible complications and functional outcome. The results were satisfactory, and no complication was observed. All the patients had complete union after 12 weeks, and the fusion was radiographically complete in all cases by 12 weeks. All patients were happy with their functional outcomes. Using the described modified arthroscopic technique, we did four total wrist arthrodeses with minimal scar, no complication and acceptable functional results.
与开放性腕关节融合术相比，关节镜下全腕关节融合术对伸肌间隔的破坏最小，瘢痕形成也较少。在本文中，我们将介绍我们采用改良手术技术进行关节镜下全腕关节融合术的经验。
通过桡腕关节和腕中关节入路进行关节镜下软骨切除后，在透视控制下继续手术。在该技术中，分别在四个不同方向插入四根钢丝（如本文所述），然后在透视控制下插入自攻空心螺钉。
在这项前瞻性研究中，共有4例患者在2年内采用我们的手术技术接受了关节镜下全腕关节融合术。所有4例患者均随访至少3个月，观察可能出现的并发症和功能结果。
结果令人满意，未观察到并发症。所有患者在12周后均实现完全愈合，所有病例在12周时影像学检查显示融合完全。所有患者对其功能结果都很满意。
采用上述改良关节镜技术，我们进行了4例全腕关节融合术，瘢痕最小，无并发症，功能结果可接受。
