Rotman M B, Manske P R, Pruitt D L, Szerzinski J
Division of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Mo 63110.
J Hand Surg Am. 1993 Jan;18(1):26-33. doi: 10.1016/0363-5023(93)90240-4.
Since 1985 scaphocapitolunate arthrodesis has been performed on 21 patients with either chronic incompetence of the scapholunate ligament or a scaphoid nonunion. The average age was 31 years; follow-up averaged 28 months. Eighty-six percent of the injuries involved workers' compensation. The operative procedure was done through a dorsal approach, with the use of autogenous bone grafting and Kirschner wire fixation. Eight-one percent healed after the primary procedure; one patient had a major infection. Range of motion averaged 35 degrees of extension, 30 degrees of flexion, 10 degrees of radial deviation, and 20 degrees of ulnar deviation. Grip strength averaged 70% of the uninvolved side. Pain was significantly reduced in 80% of the patients. Sixteen of 20 patients were able to return to work. Radiographic examination at final follow-up showed mild degenerative changes at the radiocarpal joint in two patients.
自1985年以来，对21例舟月韧带慢性功能不全或舟骨不愈合的患者实施了舟头月关节融合术。平均年龄为31岁；平均随访28个月。86%的损伤涉及工伤赔偿。手术通过背侧入路进行，采用自体骨移植和克氏针固定。81%的患者在初次手术后愈合；1例患者发生严重感染。活动范围平均为伸展35度、屈曲30度、桡偏10度和尺偏20度。握力平均为未受累侧的70%。80%的患者疼痛明显减轻。20例患者中有16例能够重返工作岗位。最后一次随访时的X线检查显示，2例患者的桡腕关节有轻度退变改变。
