Niigata Rheumatic Center, Shibata, Niigata, Japan.
Mod Rheumatol. 2021 Jan;31(1):114-118. doi: 10.1080/14397595.2020.1726607. Epub 2020 Mar 30.
Digital joints affected by rheumatoid arthritis often have severe deformity and/or dislocation, and arthrodesis in a functional position is required.
Arthrodesis was performed using intraosseous wiring (modified Lister's method) from January 2011 to December 2015, and we investigated the union rate, postoperative complications, and patient satisfaction with the operation at the final follow-up. The DASH score, grip power, and pinch power were also investigated before the operation and at the final follow-up.
Arthrodesis was performed for 90 digital joints in 56 patients. Bone union was obtained in 85 of 89 joints (96%). Wire removal was needed due to subcutaneous protrusion in 20 joints and superficial infection in five joints. The mean preoperative DASH score of 50.5 improved to 45.2 at the final follow-up. The pulp pinch power of the index fingers through the little fingers changed significantly. In the questionnaire regarding the operated digit using a visual analogue scale (VAS, 0 [worst] to 100 [best]), the overall satisfaction was 70.
With this approach, we achieved painless stability as well as deformity correction. A restored prehensile pattern and improvement in the activities of daily life can thus be expected after surgery.
受类风湿关节炎影响的数字关节常伴有严重的畸形和/或脱位，需要在功能位置进行融合。
我们于 2011 年 1 月至 2015 年 12 月期间采用骨内穿线（改良的李斯特法）进行融合术，在最终随访时我们调查了融合率、术后并发症以及患者对手术的满意度。在术前和最终随访时，我们还调查了 DASH 评分、握力和捏力。
56 例患者的 90 个数字关节接受了融合术。89 个关节中的 85 个（96%）获得了骨融合。由于 20 个关节出现皮下突出和 5 个关节出现浅表感染，需要取出缝线。术前 DASH 评分平均为 50.5，最终随访时降至 45.2。食指至小指的指腹捏力明显改变。在使用视觉模拟量表（VAS，0 [最差] 至 100 [最好]）的调查问卷中，患者对手术手指的总体满意度为 70。
采用这种方法，我们实现了无痛稳定和畸形矫正。术后可预期恢复抓握模式和日常生活活动能力的改善。
