Orthopaedic Hospital Vienna-Speising, 1st Departement, Speisinger Straße 109, 1130, Vienna, Austria.
Dr. Borchert Medical Information Management, Egelsbacher Str. 39E, 63225, Langen, Germany.
Arch Orthop Trauma Surg. 2023 Jul;143(7):4557-4564. doi: 10.1007/s00402-023-04785-2. Epub 2023 Feb 9.
The prime requisites of a good digital arthrodesis are a painless and stable union in a proper position. Arthrodesis of the distal interphalangeal joint of the fingers is not without potential complications including nonunion, malunion, and deep tissue infections. The Shark Screw is a human, cortical bone allograft for osteosynthesis and an alternative to metal or bioabsorbable devices in orthopedics and trauma surgery. The primary hypothesis is that the fusion and complication rate, using the Shark Screw, is at least similar to those reported in the literature, using metal or bioabsorbable screws.
This retrospective cohort study analyzes the fusion and complication rate and the patient satisfaction of distal interphalangeal joint arthrodesis of 27 fingers with the human allogeneic cortical bone screw. Complications, Disabilities of Arm, Shoulder, and Hand Questionnaire (Quick-DASH) score and Michigan Hand Outcomes Questionnaire (MHQ) score, grip and pinch strength and fusion angle were investigated.
The mean follow-up was 23 months. At 6 weeks after surgery, fusion was obtained for all fingers. There was no surgical complication that required revision surgery. An average fusion angle of 13.6° ± 10.7° was measured. VAS pain score decreased significantly from 6.9 before surgery to 0.14 after surgery. The Quick-DASH score decreased from 10.7 to 7.8. The MHQ score improved in all sub-scores.
The complication rates, using the Shark Screw for DIP joint arthrodesis, are lower compared to the results reported in the literature for other surgical techniques. Complications related to the human allograft cortical bone screw itself were not observed. The bone screw is completely remodeled into the host bone and further hardware removal is not necessary.
IV.
良好的数字关节融合术的基本要求是无痛且稳定地在适当的位置愈合。手指末节指间关节融合术并非没有潜在并发症，包括不愈合、畸形愈合和深部组织感染。鲨鱼钉是一种用于骨合成的人皮质骨同种异体移植物，是骨科和创伤外科金属或可吸收装置的替代物。主要假设是，使用鲨鱼钉的融合和并发症发生率至少与文献中报道的使用金属或可吸收螺钉的发生率相似。
本回顾性队列研究分析了 27 根手指末节指间关节融合术使用同种异体皮质骨螺钉的融合和并发症发生率以及患者满意度。调查了并发症、手臂、肩部和手残疾问卷（Quick-DASH）评分和密歇根手功能问卷（MHQ）评分、握力和捏力以及融合角度。
平均随访 23 个月。术后 6 周时，所有手指均融合。没有需要再次手术的手术并发症。平均融合角度为 13.6°±10.7°。VAS 疼痛评分从术前的 6.9 显著下降到术后的 0.14。Quick-DASH 评分从 10.7 下降到 7.8。所有子评分的 MHQ 评分均有所提高。
与文献中报道的其他手术技术相比，使用鲨鱼钉进行 DIP 关节融合术的并发症发生率较低。未观察到与同种异体皮质骨螺钉本身相关的并发症。骨螺钉完全重塑为宿主骨，不需要进一步去除内固定。
IV。
