Department of Orthopaedic Surgery, Inha University Hospital, Incheon 22332, Korea.
Medicina (Kaunas). 2022 Oct 13;58(10):1442. doi: 10.3390/medicina58101442.
: Although distal interphalangeal (DIP) arthrodesis is an effective surgical method for end-stage osteoarthritis of the phalangeal joint, the nonunion rate of DIP arthrodesis has been reported to range from 15% to 20%. To this end, we devised an inlay technique with a cortico-cancellous olecranon bone graft for failed DIP arthrodesis. This study aimed to introduce the inlay bone grafting technique for failed arthrodesis of the DIP joint and demonstrate its advantages. : We reviewed consecutive 19 digits (15 patients) who had undergone DIP revision arthrodesis using the technique at our institution between January 2010 and December 2020. The observed outcome measures were the bone union rate, and related complications. Bone union was evaluated using follow-up radiography. The quick Disabilities of the Arm, Shoulder and Hand (DASH), visual analog scale (VAS) for pain, and VAS for satisfaction assessed patient function and perceived clinical outcomes. : No major complications were observed at the recipient site. The average VAS for pain and satisfaction and DASH score improved from preoperatively to 6 months after surgery (both, = 0.001). : The inlay technique with cortico-cancellous olecranon bone grafts showed excellent bone union rates and functional scores with nonunion of the DIP joint. This technique may be an adequate surgical option for patients with confirmed nonunion of the DIP joint and persistent symptoms.
: 尽管远节指间(DIP)关节融合术是治疗指间关节晚期骨关节炎的有效手术方法,但 DIP 关节融合术的不愈合率据报道为 15%至 20%。为此,我们设计了一种带有皮质松质鹰嘴骨移植物的镶嵌技术,用于治疗 DIP 融合失败。本研究旨在介绍 DIP 关节融合失败的镶嵌植骨技术,并展示其优势。 : 我们回顾了 2010 年 1 月至 2020 年 12 月期间在我院接受 DIP 翻修融合术的 19 个手指(15 例患者)。观察的结果指标是骨愈合率和相关并发症。通过随访 X 线片评估骨愈合。快速上肢功能障碍问卷(DASH)、疼痛视觉模拟评分(VAS)和满意度 VAS 评估患者的功能和感知临床结果。 : 未在受区观察到重大并发症。疼痛和满意度 VAS 以及 DASH 评分从术前到术后 6 个月均有改善(均, = 0.001)。 : 带皮质松质鹰嘴骨移植物的镶嵌技术显示出极好的骨愈合率和功能评分,且 DIP 关节无融合。对于 DIP 关节融合失败且症状持续存在的患者,该技术可能是一种合适的手术选择。