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关节镜下 4 角融合术结合 2 枚无头螺钉治疗的疗效分析。

Treatment Outcomes of All Arthroscopic 4-Corner Arthrodesis Techniques With 2 Headless Screws.

机构信息

Department of Orthopedics and Traumatology, Selcuk University, Konya, Turkey.

Department of Hand Surgery, Gazi Yasargil Education and Research Hospital, Diyarbakır, Turkey.

出版信息

J Hand Surg Am. 2023 Dec;48(12):1278.e1-1278.e8. doi: 10.1016/j.jhsa.2022.05.004. Epub 2022 Jul 7.

Abstract

PURPOSE

Scaphoid excision with 4-corner arthrodesis is a safe procedure that relieves pain while also preserving the functional movements of the wrist. Different techniques have been described with successful results. In this study, we present the midterm clinical outcomes of 17 patients who underwent treatment with our arthroscopic 4-corner arthrodesis technique.

METHODS

Patients with at least 1 year of follow-up were included in our study. Preoperative and postoperative radiologic, functional, and clinical results were compared. Radiologic and clinical union were achieved in all patients.

RESULTS

Significant improvement was observed in Quick Disabilities of the Arm, Shoulder, and Hand, Mayo Wrist Score, visual analog scale, and Patient-Rated Wrist Evaluation scores. Although wrist range of motion increased in the radioulnar plane, no clinically important change was observed in the flexion-extension arc. The patients were able to return to work in an average of 10 weeks.

CONCLUSIONS

The arthroscopic 4-corner arthrodesis technique is a method with satisfactory outcomes. The main disadvantage of this procedure is that it requires a lengthy operative time, and both specific expertise and equipment.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

摘要

目的

舟状骨切除四关节融合术是一种安全的手术,既能缓解疼痛,又能保留腕关节的功能活动。已经描述了不同的技术,都取得了成功的结果。在这项研究中,我们介绍了 17 例接受我们关节镜下四关节融合术治疗的患者的中期临床结果。

方法

我们的研究纳入了至少随访 1 年的患者。比较了术前和术后的影像学、功能和临床结果。所有患者均达到影像学和临床愈合。

结果

在手臂、肩部和手的快速残疾、腕关节 Mayo 评分、视觉模拟评分和患者自评腕关节评分方面均有显著改善。虽然桡尺骨平面的腕关节活动度增加,但屈伸弧没有观察到临床重要的变化。患者平均在 10 周内恢复工作。

结论

关节镜下四关节融合术是一种疗效满意的方法。该手术的主要缺点是手术时间长,需要特定的专业知识和设备。

研究类型/证据水平:治疗性 IV 级。

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