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腕骨损伤多种严重结局的再成形头状骨焦碳植入物补救治疗。临床经验与随访。

Resurfacing capitate pyrocarbon implant as salvage procedure in several serious outcomes of carpal injuries. Clinical experience and follow-up.

机构信息

Modena University Hospital, Department of Hand Surgery, Modena, Italy.

Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. Università Cattolica del Sacro Cuore, Roma, Italia..

出版信息

Acta Biomed. 2022 Mar 10;92(S3):e2021536. doi: 10.23750/abm.v92iS3.12486.

Abstract

BACKGROUND AND AIM

Resurfacing Capitate Pyrocarbon Implant has been introduced in the surgical practice as an alternative method to restore wrist motion, strength and functions in patients suffering from wrist osteoarthritis. It has already been well described in the literature as a treatment for advanced stages of degenerative wrist diseases which follow scaphoid's and lunate's injuries such as scapho-lunate advanced collapse, scaphoid non-union advanced collapse, and advanced stages of Kienböck disease. Authors extended the use of RCPI to other selected cases of complicated wrist injuries, spreading out from the classic indications for which this device was designed.

METHODS

We discuss 8 cases with serious outcomes of carpal injuries treated with Resurfacing Capitate Pyrocarbon Implant as salvage procedure between 2005 and 2013 by the first author of this paper Results: Among the eight particular selected cases, at a mean 4.3 years follow-up (range 2-11) only one was considered a failure and underwent a total wrist arthrodesis, resolving pain after all. The seven other cases reported good results. Range of Motion, Visual Analogue Scale for pain, subjective satisfaction and radiographical outcomes are reported.

CONCLUSIONS

As a result of this heterogeneous clinical experience, validated by long-term follow-ups in most cases, we think that the use of a Resurfacing Capitate Pyrocarbon Implant can be suggested as an option in the outcomes of various carpal injuries.

摘要

背景与目的

表面置换腕舟骨植入物已在临床实践中作为一种替代方法被引入,用于恢复腕关节炎患者的腕部运动、力量和功能。它已经在文献中被很好地描述为治疗腕部退行性疾病的晚期阶段,这些疾病继发于舟骨和月骨损伤,如舟月骨进行性塌陷、舟骨不愈合性进行性塌陷和进展性月骨骨软骨病。作者将 RCPI 的应用扩展到其他选定的复杂腕部损伤病例,超出了该设备设计的经典适应证。

方法

我们讨论了 8 例由第一作者于 2005 年至 2013 年间采用表面置换腕舟骨植入物作为挽救性手术治疗的严重腕部损伤病例。结果:在这 8 例特定的选择病例中,在平均 4.3 年的随访(范围 2-11 年)中,仅 1 例被认为失败并接受了全腕关节融合术,所有患者的疼痛均得到缓解。其余 7 例报告了良好的结果。报告了关节活动度、疼痛视觉模拟评分、主观满意度和影像学结果。

结论

由于这种异质的临床经验,并且在大多数病例中进行了长期随访,我们认为在各种腕部损伤的结果中,使用表面置换腕舟骨植入物可以作为一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad6b/9437692/74a686cda0ad/ACTA-92-536-g002.jpg

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