Abstract:
We assessed the effect of four-corner intercarpal fusion with locking plate without bone graft on daily activities and pain in patients with stage II and III scapholunate advanced collapse and scaphoid nonunion. Twenty-one patients who underwent four-corner fusion with scaphoidectomy without bone graft were evaluated with the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Visual Analog Scale (VAS) pain scores before and 16 months after surgery. We also compared postoperative grip strength between the operated and the healthy side. A principal component analysis was used to establish the relationship between functional benefit, immobilization period and number of physiotherapy sessions. We compared our results with published data. VAS and QuickDASH scores improved significantly. Loss of strength was observed postoperatively. QuickDASH score improved the most with a short immobilization period. No significant difference was found relative to the literature for follow-up time, range of motion, grip strength and QuickDASH score. All patients had bone fusion after 1 year. Four-corner fusion with locking plate is a procedure that reduces pain and improves functional scores. Our results are equal to those reported in the literature with bone graft. The union rate seemed high despite the absence of bone graft but was only assessed by x rays. This study allowed us to establish a treatment guideline: a shorter immobilization leads to better recovery.
摘要:
我们评估了不带植骨的锁定钢板的四角腕间融合术对II期和III期舟骨晚期塌陷和舟骨骨不连患者日常活动和疼痛的影响。对21例接受四角融合的患者进行了评估,这些患者没有进行骨移植,手术前和手术后16个月的肩手(QuickDASH)和视觉模拟量表(VAS)疼痛评分。我们还比较了手术和健康侧的术后握力。使用主成分分析来建立功能效益与功能效益之间的关系,固定期和物理治疗次数。我们将我们的结果与发表的数据进行了比较。VAS和QuickDASH得分显著提高。术后观察到力量丧失。QuickDASH分数在较短的固定时间内提高最大。随访时间相对于文献没有发现显著差异,运动范围,握力和QuickDASH得分。所有患者均在1年后进行骨融合。带有锁定板的四角融合是一种减轻疼痛并改善功能评分的方法。我们的结果与文献中报道的骨移植结果相同。尽管没有植骨,但愈合率似乎很高,但只能通过X射线进行评估。这项研究使我们能够建立治疗指南:较短的固定导致更好的恢复。