Leibovic S J, Strickland J W
Department of Orthopedic Surgery, Medical College of Virginia, Richmond.
J Hand Surg Am. 1994 Mar;19(2):181-8. doi: 10.1016/0363-5023(94)90002-7.
We report a retrospective review of 224 proximal interphalangeal joint arthrodeses in the digits using Herbert screws (37), Kirschner wires (100), tension band wiring (69), plates (11), and other miscellaneous techniques (7) for fixation. Average time to clinical union was 7 weeks and time to radiographic union was 10 weeks. Nonunion occurred in 31 cases (24 digits). The primary nonunion rate was highest in psoriatic arthritis, intermediate in rheumatoid arthritis, lower in acute trauma and post-traumatic reconstruction, and nonexistent in osteoarthritis. The primary nonunion rate was highest using Kirschner wires, intermediate using tension band wires, and lowest using Herbert screws. All Kirschner wires, six tension band wires and one Herbert screw were removed after fusion. The Herbert screw provides secure fixation, is easy to insert, and affords a rapid and reliable arthrodesis at the proximal interphalangeal joint.
我们报告了一项对224例手指近端指间关节融合术的回顾性研究，这些手术采用Herbert螺钉（37例）、克氏针（100例）、张力带钢丝（69例）、钢板（11例）及其他各种技术（7例）进行固定。临床愈合的平均时间为7周，影像学愈合时间为10周。31例（24指）出现不愈合。原发性不愈合率在银屑病关节炎中最高，类风湿关节炎中次之，急性创伤和创伤后重建中较低，骨关节炎中不存在。使用克氏针时原发性不愈合率最高，张力带钢丝次之，Herbert螺钉最低。融合后所有克氏针、6根张力带钢丝和1枚Herbert螺钉均被取出。Herbert螺钉提供可靠固定，易于插入，并能在近端指间关节实现快速且可靠的关节融合。
