Seitz W H, Sellman D C, Scarcella J B, Froimson A I
Mt. Sinai Medical Center, Department of Orthopaedic Surgery, Cleveland, OH 44106-4198.
Clin Orthop Relat Res. 1994 Jul(304):116-21.
A number of techniques for achieving small joint arthrodesis in the hand combine various forms of internal fixation with external cast or splint immobilization. Rates of arthrodesis in most cases are quite high. However, the prolonged period of adjacent joint immobilization from casting can extend rehabilitation time and limit hand function during healing. Compression arthrodesis has been used effectively in a number of larger joints, such as the knee and ankle. Miniaturization of existing external fixation compression devices now enables the application of this principle to the small joints of the hand. A series of 20 metacarpophalangeal and interphalangeal joints underwent arthrodesis in which a miniature external fixation/compression frame was used. Nineteen of 20 joints demonstrated complete primary arthrodesis within 6 weeks; one fibrous union developed in a distal interphalangeal joint and no postoperative deformities occurred. Complete stabilization was provided by the fixator, thus allowing immediate postoperative adjacent joint function.
一些用于手部小关节融合的技术将各种形式的内固定与外部石膏或夹板固定相结合。大多数情况下关节融合率相当高。然而，石膏固定导致的相邻关节长时间固定会延长康复时间，并在愈合期间限制手部功能。加压融合术已在一些较大关节（如膝关节和踝关节）中得到有效应用。现有外固定加压装置的小型化现在使得这一原理能够应用于手部小关节。对一系列20个掌指关节和指间关节进行了融合术，其中使用了微型外固定/加压框架。20个关节中有19个在6周内实现了完全一期融合；一个远侧指间关节出现纤维性愈合，且未发生术后畸形。固定器提供了完全稳定，从而允许术后立即恢复相邻关节功能。
