Service d'Orthopédie 1 et Traumatologie, Hôpital Roger Salengro, F-59000, Lille, France.
Service d'Orthopédie 1 et Traumatologie, Hôpital Roger Salengro, F-59000, Lille, France.
Injury. 2024 Jun;55 Suppl 1:111350. doi: 10.1016/j.injury.2024.111350. Epub 2024 Jul 26.
This study aimed to assess clinical, functional and radiological outcomes after three-corner arthrodesis in patients suffering from symptomatic scapholunate or scaphoid non-union advanced collapsed wrists. We hypothesised that three-corner arthrodesis provided satisfactory clinical and radiological results in the long term.
This was a retrospective study of 13 patients (14 wrists) who underwent a three-corner arthrodesis between March 2004 and January 2019 with a mean follow-up of 6,7 years. Clinical assessment consisted of wrist motion, grip strength, pain and functional scores (Quick-DASH, PRWE, MWS). All complications and surgical revisions were investigated. Radiographic assessment searched for union, evaluated carpal height and ulnar translation, lunate tilt and occurrence of radio-lunate arthritis.
At the last follow-up Quick-DASH and PRWE scores were 24,87(± 17.2) and 47.4 (± 26.9) respectively and were significantly improved. Wrist motion was 35°, 32°, 10° et 24° of flexion, extension, radial and ulnar deviation respectively. Union was obtained for 13 (92,9%) wrists. The mean radiolunate angle was 11° (-17°-34°). Three patients needed reintervention, which 2 consisted of total wrist arthrodesis due to persisting pain. Mild signs of radio-lunate arthritis were found in three patients.
Three-corner arthrodesis seemed to provide satisfactory long-term functional outcomes. The union rate was high and even patients with signs of radio-lunate arthritis still had improved outcomes at the last follow-up. It could be a part of surgical options in wrists with radio- and midcarpal arthritis, among other procedures.
本研究旨在评估三角骨切除术治疗症状性舟月或舟骨骨不连晚期塌陷腕关节患者的临床、功能和影像学结果。我们假设三角骨切除术在长期内提供满意的临床和影像学结果。
这是一项回顾性研究，纳入了 2004 年 3 月至 2019 年 1 月期间接受三角骨切除术的 13 例（14 腕）患者，平均随访 6.7 年。临床评估包括腕关节活动度、握力、疼痛和功能评分（Quick-DASH、PRWE、MWS）。所有并发症和手术修正均进行了调查。影像学评估包括愈合情况、腕骨高度和尺骨位移、月骨倾斜和发生腕骨关节炎的情况。
末次随访时，Quick-DASH 和 PRWE 评分分别为 24.87（±17.2）和 47.4（±26.9），均显著改善。腕关节活动度为 35°、32°、10°和 24°的屈、伸、桡偏和尺偏。13 （92.9%）腕关节获得愈合。平均桡月角为 11°（-17°-34°）。3 例患者需要再次干预，其中 2 例因持续疼痛行全腕关节融合术。3 例患者出现轻度腕骨关节炎征象。
三角骨切除术似乎提供了令人满意的长期功能结果。愈合率高，即使有腕骨关节炎迹象的患者在末次随访时仍有改善。它可能是其他手术的一部分，如腕关节和中腕关节炎的手术选择之一。
