Owen David H, Wang Dongyang, Cong Xu, Mowbray Cameron, Perriman Diana M, Roberts Chris J, Smith Paul N, Drobetz Herwig, Ackland David
Canberra Hospital, ACT, Australia.
Australian National University Medical School, Canberra, ACT, Australia.
Hand (N Y). 2025 Mar;20(2):230-236. doi: 10.1177/15589447231198263. Epub 2023 Oct 7.
It is unknown whether total wrist arthrodesis (TWA) should be performed with or without arthrodesis of the carpometacarpal joint (CMCJ). The aim of this study is to compare CMCJ-spanning TWA plates using 3D printed wrist arthrodesis model with and without arthrodesis of the CMCJ.
Total wrist arthrodesis plates mounted to 3D printed models were tested under a 4-N bending load at 4 Hz for 50 000 cycles, increased by 15% every 10 000 cycles until failure.
Plates with arthrodesis CMCJ were stiffer and failed at a significantly greater load and number of cycles than plates mounted to models without CMCJ arthrodesis. The Synthes stainless steel locking TWA plate performed better than the Trimed plate applied to the model without CMCJ arthrodesis and the Acumed plate applied to the model with CMCJ arthrodesis. Based on these findings, we recommend arthrodesis of the CMCJ in TWA.
Incorporation of the CMCJ in TWA may protect against plate failure. If arthrodesis of the CMCJ is not performed, plate removal should be considered before breakage occurs.
IV.
全腕关节融合术（TWA）是否应同时进行腕掌关节（CMCJ）融合尚不清楚。本研究的目的是使用3D打印的腕关节融合模型，比较融合与不融合CMCJ的跨越CMCJ的TWA钢板。
安装在3D打印模型上的全腕关节融合钢板在4Hz频率下承受4N的弯曲载荷，进行50000次循环测试，每10000次循环增加15%，直至失效。
融合CMCJ的钢板比安装在未融合CMCJ模型上的钢板更硬，在显著更高的载荷和更多的循环次数下失效。Synthes不锈钢锁定TWA钢板在应用于未融合CMCJ的模型时，表现优于Trimed钢板；在应用于融合CMCJ的模型时，表现优于Acumed钢板。基于这些发现，我们建议在TWA中进行CMCJ融合。
在TWA中融合CMCJ可能防止钢板失效。如果不进行CMCJ融合，应在钢板断裂前考虑取出。
IV级。
