Graduate School, Kunming Medical University, Kunming, P. R. China; Department of Orthopedics, 920th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Kunming, P. R. China.
Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P. R. China; Engineering Laboratory of Peptides of Chinese Academy of Sciences, Key Laboratory of Bioactive Peptides of Yunnan Province, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, National Resource Center for Non-Human Primates, National Research Facility for Phenotypic & Genetic Analysis of Model Animals (Primate Facility), and Sino-African Joint Research Center, New Cornerstone Science Laboratory, Kunming Institute of Zoology, the Chinese Academy of Sciences, Kunming, P. R. China.
J Plast Surg Hand Surg. 2024 Aug 29;59:95-101. doi: 10.2340/jphs.v59.40353.
Exploring the therapeutic effects of Ni-Ti shape memory alloy four-corner arthrodesis concentrator (NT-FCAC) in treating scaphoid nonunion advanced collapse (SNAC) and providing a decade-long follow-up report.
Twenty-six patients with SNAC underwent scaphoidectomy, along with four-corner arthrodesis fusion involving the capitate, lunate, triquetrum, and hamate, using NT-MFCAC. Grip strength was measured using a Jamar dynamometer, while wrist joint mobility was assessed using a goniometer. Preoperative and postoperative assessments were conducted using the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire to monitor limb functionality restoration. Pain levels at the wrist joint were evaluated using the visual analog scale (VAS). Postoperative wrist bone fusion status was assessed through anteroposterior and lateral radiographs of the wrist joint.
After a 3-month postoperative period, all 26 patients exhibited osseous union at the wrist joint. Over a follow-up spanning 10-15 years, no severe postoperative complications were observed in any patient. Grip strength in the affected side of all patients recovered to 81.96% compared to the healthy side, while wrist joint mobility in the affected side reached over 60% of the healthy side's functionality. VAS scores decreased significantly from 5.85 ± 0.73 preoperatively to 0.19 ± 0.40 at the final follow-up; Quick DASH scores reduced from 69.88 ± 5.12 preoperatively to 6.30 ± 1.25 at final follow-up. Statistically significant differences were noted in VAS and Quick DASH scores for all patients (p < 0.05). However, beyond 60 months postoperatively, subsequent follow-ups did not yield statistically significant differences in VAS and Quick DASH scores for all patients (p > 0.05).
Utilizing NT-FCAC for SNAC treated with four-corner arthrodesis fusion results in a high rate of wrist bone fusion, preserving a significant portion of wrist joint function and exhibiting favorable long-term outcomes. This approach is suitable for treating patients with SNAC requiring four-corner arthrodesis fusion.
探讨镍钛形状记忆合金四角融合器（NT-FCAC）在治疗舟状骨骨不连伴严重塌陷（SNAC）中的治疗效果，并提供长达 10 年的随访报告。
26 例 SNAC 患者行舟状骨切除术，同时采用 NT-MFCAC 进行包括头状骨、月骨、三角骨和钩骨在内的四角融合术。使用 Jamar 握力计测量握力，使用量角器评估腕关节活动度。使用快速残疾的手臂、肩和手（Quick DASH）问卷评估术前和术后上肢功能恢复情况。使用视觉模拟评分（VAS）评估腕关节疼痛程度。术后通过腕关节前后位和侧位 X 线片评估腕骨融合情况。
术后 3 个月，26 例患者均获得腕关节骨性融合。随访 10-15 年，所有患者均无严重术后并发症。所有患者患侧握力恢复至健侧的 81.96%，腕关节活动度恢复至健侧的 60%以上。VAS 评分从术前的 5.85±0.73 显著降低至末次随访时的 0.19±0.40；Quick DASH 评分从术前的 69.88±5.12 显著降低至末次随访时的 6.30±1.25。所有患者的 VAS 和 Quick DASH 评分均有统计学差异（p<0.05）。但术后 60 个月后，所有患者的 VAS 和 Quick DASH 评分无统计学差异（p>0.05）。
采用 NT-FCAC 进行四角融合术治疗 SNAC 可获得较高的腕骨融合率，保留了腕关节功能的大部分，并获得了良好的长期疗效。该方法适用于需要四角融合术的 SNAC 患者。
