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舟月关节成形术:10 例腕掌关节假体置换和改良性大多角骨切除术的报告。

Scaphometacarpal arthroplasty: a report of ten cases of trapeziometacarpal prosthesis and trapeziectomy revision.

机构信息

Unité main Orthosud, Clinique Saint Jean, Montpellier, France.

Clinique Ambroise Paré, Thionville, France.

出版信息

J Hand Surg Eur Vol. 2020 Jun;45(5):483-487. doi: 10.1177/1753193419900470. Epub 2020 Jan 28.

Abstract

Loosening of the trapezial component is a main cause of failure of trapeziometacarpal prostheses. This report presents the preliminary results of scaphometacarpal prostheses used for revision of trapeziometacarpal prostheses and failed trapeziectomies. A retrospective multicentre study was conducted on ten patients. Four had revision surgery after failure of trapeziometacarpal prostheses, five after trapeziectomy and one after a trapezial silicone implant. Pain, mobility, strength, QuickDASH, satisfaction score and radiographs were assessed. Nine patients were assessed (one was lost to follow-up), with a mean follow-up of 34 months. The mean pain score was 1.2/10, Quick-DASH was 39 and opposition according to the Kapandji score was 8.6. Strength was 3 kg for key pinch and 13.6 kg for power grip. One failure was observed, with early loosening of the scaphoid cup. Scaphometacarpal arthroplasty is a reliable medium-term solution for revision of the loosening of a trapeziometacarpal prosthesis with trapezial damage and for failed trapeziectomy. IV.

摘要

远侧桡腕关节假体是治疗腕掌关节假体松动和失败性腕骨切除术的有效方法。本研究报告了远侧桡腕关节假体应用于腕掌关节假体翻修和失败性腕骨切除术的初步结果。采用回顾性多中心研究方法,对 10 例患者进行了研究。4 例患者因腕掌关节假体失败而进行翻修手术,5 例因腕骨切除术,1 例因硅胶植入腕骨而进行翻修手术。评估了疼痛、活动度、力量、QuickDASH 评分、满意度评分和影像学检查。9 例患者(1 例失访)接受了平均 34 个月的随访。平均疼痛评分为 1.2/10,Quick-DASH 评分为 39,Kapandji 评分的对掌功能为 8.6。握力为 3kg 示指对捏,13.6kg 握力。观察到 1 例失败病例,表现为早期舟状骨杯松动。远侧桡腕关节成形术是治疗伴有舟状骨损伤的腕掌关节假体松动和失败性腕骨切除术的一种可靠的中期治疗方法。

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