Abstract:
The clinical implication of a residual flexion deformity following surgery for scaphoid nonunion is unclear. Sixty-three patients who underwent scaphoid nonunion surgery were assessed after a mean of 7 years (range 5-10) to analyse the outcomes based on the presence of residual scaphoid deformity. Primary outcome was Disabilities of the Arm, Shoulder and Hand score. Secondary outcomes were Patient-Rated Wrist Evaluation score, wrist range of motion and strength. Patients were dichotomized to residual deformity or no deformity. Scaphoid deformity was calculated from CT scans based on the median difference between the height-length ratio of the operated versus the uninjured scaphoid. There were no differences between residual deformity (n = 33) and no deformity (n = 30) in any outcome variables, except for wrist extension which was slightly worse in the deformity group. The deformity group had a greater number of radiographic osteoarthritis, but all cases were mild, and osteoarthritis did not correlate to a worse outcome. We conclude that residual scaphoid deformity has no relevant negative impact on mid-term wrist function.Level of evidence: IV.
摘要:
舟骨骨不连手术后残余屈曲畸形的临床意义尚不清楚。平均7年(5-10年)后对63例接受舟骨骨不连手术的患者进行了评估,以根据残留的舟骨畸形的存在分析结果。主要结果是手臂残疾,肩和手得分。次要结果为患者评估腕部评分,手腕的运动范围和力量。将患者分为残留畸形或无畸形。通过CT扫描,根据手术者与未受伤的舟骨的身高长度比之间的中值差异,计算出舟骨畸形。在任何结果变量中,残余畸形(n=33)和无畸形(n=30)之间没有差异,除了畸形组的腕关节伸展稍差。畸形组有更多的影像学骨性关节炎,但所有病例都很轻微,骨关节炎与更差的结果无关。我们得出的结论是,残余的舟骨畸形对中期腕关节功能没有相关的负面影响。证据级别:IV。