Wyrick J D, Stern P J, Kiefhaber T R
Cincinnati Hand Surgery Consultants, OH 45206, USA.
J Hand Surg Am. 1995 Nov;20(6):965-70. doi: 10.1016/S0363-5023(05)80144-3.
Seventeen patients were treated with scaphoid excision and four-corner arthrodesis (lunate, capitate, hamate, triquetrum) for scapholunate advanced collapse wrist and followed for a mean of 27 months. Eleven wrists in 10 patients had a proximal row carpectomy for scapholunate advanced collapse wrist and were followed for a mean of 37 months. The total arc of motion averaged 95 degrees in the four-corner arthrodesis patients and 115 degrees in the proximal row carpectomy patients, which was 47% and 64%, respectively, of the range of motion of the opposite wrist. Grip strength averaged 74% of the opposite wrist in the four-corner arthrodesis group and 94% in the proximal row carpectomy group. Three wrists in the four-corner arthrodesis group failed and were successfully converted to a total wrist fusion; two additional patients were awaiting arthrodesis. There were no failures in the proximal row carpectomy group. Proximal row carpectomy showed a high degree of patient satisfaction and is our motion-preserving procedure of choice except in those wrists with advanced capitolunate arthritis.
17例舟月骨晚期塌陷性腕关节患者接受舟骨切除及四角融合术（月骨、头状骨、钩骨、三角骨）治疗，平均随访27个月。10例患者的11个腕关节接受了近排腕骨切除术治疗舟月骨晚期塌陷性腕关节，平均随访37个月。四角融合术患者的总活动弧度平均为95度，近排腕骨切除术患者为115度，分别为对侧腕关节活动范围的47%和64%。四角融合术组握力平均为对侧腕关节的74%，近排腕骨切除术组为94%。四角融合术组有3个腕关节手术失败，成功转为全腕关节融合术；另有2例患者等待关节融合术。近排腕骨切除术组无失败病例。近排腕骨切除术患者满意度较高，是我们保留运动功能的首选术式，除非伴有晚期头月关节关节炎的腕关节。
