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采用掌侧锁定钢板治疗舟骨不愈合

TREATMENT OF SCHAPHOID NONUNION WITH VOLAR LOCKED PLATE.

作者信息

Burgos Felipe Hellmeister, Nakamoto João Carlos, Nakamoto Hugo Alberto, Iwase Fernanda do Carmo, Mattar Rames

机构信息

Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas (HCFMUSP), Orthopedics and Traumatology Institute, Hand and Microsurgery Group, São Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2019 May-Jun;27(3):141-145. doi: 10.1590/1413-785220192703214849.

Abstract

OBJECTIVE

To assess and compare radiographic, tomographic and functional pre and postoperative parameters of patients submitted to treatment of nonunion of the scaphoid waist with locked plate for scaphoid.

METHODS

This is a case series of scaphoid waist nonunion, operated from March 2017 to March 2018 at the Institute of Orthopedics and Traumatology of HCFMUSP, using the technique of Fisk-Fernandez and osteosynthesis with locked plate for scaphoid APTUS®Hand from Medartis. The patients were submitted to radiographs, computed tomography and functional evaluation by the occupational therapy team in the pre and postoperative periods.

RESULTS

There was consolidation of the scaphoid waist nonunion in all cases, improvement in the parameters of carpal alignment in the imaging examinations, but functionally we observed reduction of the range of motion and grip strength in relation to the contralateral limb.

CONCLUSIONS

The treatment of the scaphoid waist nonunion with locked plate was effective, with a high index of consolidation and improvement of the carpal alignment in the imaging tests, although with a reduction in the range of motion and grip strength in relation to the contralateral limb when evaluated with 12 weeks postoperatively.

摘要

目的

评估并比较采用舟状骨锁定钢板治疗舟状骨腰部骨不连患者术前和术后的影像学、断层扫描及功能参数。

方法

这是一组舟状骨腰部骨不连病例系列,于2017年3月至2018年3月在HCFMUSP骨科学与创伤学研究所进行手术,采用Fisk-Fernandez技术及Medartis公司的APTUS®Hand舟状骨锁定钢板进行骨合成。患者在术前和术后均接受了X线摄影、计算机断层扫描以及职业治疗团队的功能评估。

结果

所有病例中舟状骨腰部骨不连均获愈合,影像学检查中腕关节对线参数有所改善,但在功能方面,与对侧肢体相比,我们观察到活动范围和握力有所降低。

结论

采用锁定钢板治疗舟状骨腰部骨不连是有效的,愈合率高且影像学检查显示腕关节对线得到改善,不过术后12周评估时,与对侧肢体相比活动范围和握力有所降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f73a/6699398/5adca9c3d275/1809-4406-aob-27-03-0141-gf01.jpg

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