Vicar A J, Burton R I
J Hand Surg Am. 1986 Nov;11(6):790-7. doi: 10.1016/s0363-5023(86)80224-6.
Forty-eight patients with 33 wrist fusions and 37 silicone wrist arthroplasties were reviewed and compared. Of those who had arthrodesis 97% showed a good or excellent result. Follow-up time averaged 82 months. All patients had a decrease in pain. Most patients had stronger wrists but complained of decreased dexterity. There were no pseudarthroses. The complication rate was 18%. Of patients in the arthroplasty group, 78% had a good or excellent result. Follow-up time averaged 51 months. Most patients in the arthroplasty group had improved dexterity and adequate wrist strength. Average flexion/extension was 32 degrees/29 degrees. The complication rate was 25%, which included four revisions. Of patients who had arthroplasties, 14% had bone resorption about the stem, and 11% of the patients with arthroplasties had x-ray evidence of settling. Factors that did not influence the result of the arthroplasty were patient age, duration of disease before surgery, finger extensor tendon rupture, preoperative motion, and hand dominance. Factors that were associated with failure and/or a fair result in arthroplasty patients were the use of ambulatory aids, the older and narrower prosthetic design, dislocated wrist preoperatively, and the chronic use of steroids.
对48例患者进行了回顾性研究并比较，其中33例行腕关节融合术，37例行硅胶腕关节置换术。接受关节融合术的患者中，97%的结果为良好或优秀。随访时间平均为82个月。所有患者的疼痛均减轻。大多数患者的腕部力量增强，但抱怨灵活性下降。未出现假关节。并发症发生率为18%。在关节置换术组中，78%的结果为良好或优秀。随访时间平均为51个月。关节置换术组的大多数患者灵活性提高，腕部力量足够。平均屈伸角度为32度/29度。并发症发生率为25%，其中包括4例翻修手术。在接受关节置换术的患者中，14%在假体柄周围出现骨吸收，11%的关节置换术患者有X线证据显示假体下沉。不影响关节置换术结果的因素包括患者年龄、术前疾病持续时间、手指伸肌腱断裂、术前活动度和用手习惯。与关节置换术患者失败和/或结果一般相关的因素包括使用助行器、较旧且较窄的假体设计、术前腕关节脱位以及长期使用类固醇。
